Anesthesia for the patient with a recently diagnosed concussion: think about the brain!

Kavin, Michelle; Stache, Stephen; Mahla, Michael E.; Schwenk, Eric S.

doi:10.4097/kja.19272

Cited by 2 publications

(3 citation statements)

References 24 publications

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“…A retrospective cohort study reported that early orthopedic and facial fracture fixation (≤ 24 h after injury) under general anesthesia was not associated with worse neuropsychological or functional outcome than late surgery in multisystem trauma patients with TBI [ 83 ]. Currently, there are no contraindications to anesthesia in TBI, and once the decision to proceed with surgery has been made, steps should be taken to reduce the risks associated with surgery based on an understanding of the pathophysiology of TBI and the interactions between surgery and application of anesthesia [ 84 ].…”

Section: Intraoperative Managementmentioning

confidence: 99%

Anesthetic management of the traumatic brain injury patients undergoing non-neurosurgery

Kim

2023

Anesth Pain Med

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This article describes the anesthetic management of patients with traumatic brain injury (TBI) undergoing non-neurosurgery, primarily targeting intraoperative management for multiple-trauma surgery. The aim of this review is to promote the best clinical practice for patients with TBI in order to prevent secondary brain injury. Based on the current clinical guidelines and evidence, anesthetic selection and administration; maintenance of optimal cerebral perfusion pressure, oxygenation and ventilation; coagulation monitoring; glucose control; and temperature management are addressed. Neurological recovery, which is critical for improving the patient’s quality of life, is most important; therefore, future research needs to be focused on this aspect.

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Section: Intraoperative Managementmentioning

confidence: 99%

Anesthetic management of the traumatic brain injury patients undergoing non-neurosurgery

Kim

2023

Anesth Pain Med

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“…Los agentes intravenosos generalmente mantienen el acoplamiento entre CMRO 2 y FSC. Por ello, en la medida que mantenga la PAM, cualquier agente intravenoso puede ser usado en esta población [16], [17]. Usualmente se usa la combinación propofol y remifentanilo (u otro opioide de acuerdo con la expectativa del despertar al final de la cirugía).…”

Section: Mantención De La Anestesiaunclassified

“…De las alteraciones con mayor impacto en el manejo y metas anestésicas se encuentran la disfunción del sistema nervioso autónomo que suele ser importante dentro de las 72 h posterior al trauma y la alteración del FSC que puede durar más de un mes, incluso en TEC leve [16].…”

Section: Cirugía Extracraneal En El Paciente Con Tecunclassified

Anestesia para el paciente con traumatismo encéfalocraneano

Avila¹

2021

Rev. chil. anest.

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Traumatic brain injury (TBI) is the leading cause of death and disability for children and young adults. The Glasgow Coma Scale allows to classify TBI as mild, moderate and severe. Imaging studies show the heterogeneity of the diagnosis. Primary injury is caused by mechanical impact. Secondary injury contributes significantly to prognosis by exacerbating hypoperfusion and intracranial hypertension. Even in the absence of extracranial lesions, many patients with severe TBI present significant organ dysfunction, which transforms TBI into a multisystemic pathology. Most relevant systems compromised include cardiovascular, autonomic, respiratory and coagulation. The main aims of anesthetic management are: early decompression together with prevention, early detection, and management of determinants of secondary injury. To date, there are no techniques or drugs showing a significant impact on the outcome of TBI patients. On the other hand, maintaining good hemodynamic stability, adequate oxygenation and normocarbia all contribute to a better outcome. RESUmENEl trauma encéfalocraneano (TEC) es la causa más importante de muerte y discapacidad de niños y adultos jóvenes. La escala de Glasgow permite clasificarlo en leve, moderado y severo. La imagenología da cuenta de la heterogeneidad del diagnóstico. La injuria primaria es la causada por el impacto mecánico. La injuria secundaria contribuye significativamente al pronóstico al exacerbar la hipoperfusión y la hipertensión endocraneana. Aun en ausencia de lesiones extracraneales, gran parte de los pacientes con TEC severo presenta disfunción orgánica significativa, lo que lo transforma en una patología multisistémica. Destacan el compromiso cardiovascular, autonómico, respiratorio y trastornos de la coagulación, entre otros. Los objetivos del manejo anestésico son: la descompresión precoz junto con la prevención, detección temprana y manejo de factores determinantes de injuria secundaria. No existe evidencia respecto de técnicas ni fármacos que hayan demostrado un impacto significativo en el manejo del TEC, más bien, impacta positivamente el mantener la estabilidad hemodinámica, una adecuada oxigenación y normocarbia.

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Anesthesia for the patient with a recently diagnosed concussion: think about the brain!

Cited by 2 publications

References 24 publications

Anesthetic management of the traumatic brain injury patients undergoing non-neurosurgery

Anesthetic management of the traumatic brain injury patients undergoing non-neurosurgery

Anestesia para el paciente con traumatismo encéfalocraneano

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