Total Intravenous Anaesthesia for War Surgery

Lewis, Sharon R; Jagdish, S

doi:10.1136/jramc-156-04s-06

Cited by 4 publications

(1 citation statement)

References 28 publications

(26 reference statements)

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“…Ketamine has been used for decades by fi eld military personnel by all routes of administration (IV, IM, oral, etc.) during armed confl icts ( 53,57,61 ). The knowhow gathered is invaluable and has been a precious source of inspiration when developing our protocols.…”

Section: Argument For the Exclusive Use Of Ketaminementioning

confidence: 98%

Potential Anesthesia Protocols for Space Exploration Missions

Komorowski¹,

Watkins²,

Lebuffe³

et al. 2013

Aviation, Space, and Environmental Medicine

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In spaceflight beyond low Earth's orbit, medical conditions requiring surgery are of a high level of concern because of their potential impact on crew health and mission success. Whereas surgical techniques have been thoroughly studied in spaceflight analogues, the research focusing on anesthesia is limited. To provide safe anesthesia during an exploration mission will be a highly challenging task. The research objective is thus to describe specific anesthesia procedures enabling treatment of pre-identified surgical conditions. Among the medical conditions considered by the NASA Human Research Program Exploration Medical Capability element, those potentially necessitating anesthesia techniques have been identified. The most appropriate procedure for each condition is thoroughly discussed. The substantial cost of training time necessary to implement regional anesthesia is pointed out. Within general anesthetics, ketamine combines the unique advantages of preservation of cardiovascular stability, the protective airway reflexes, and spontaneous ventilation. Ketamine side effects have for decades tempered enthusiasm for its use, but recent developments in mitigation means broadened its indications. The extensive experience gathered in remote environments, with minimal equipment and occasionally by insufficiently trained care providers, confirms its high degree of safety. Two ketamine-based anesthesia protocols are described with their corresponding indications. They have been designed taking into account the physiological changes occurring in microgravity and the specific constraints of exploration missions. This investigation could not only improve surgical care during long-duration spaceflights, but may find a number of terrestrial applications in isolated or austere environments.

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Section: Argument For the Exclusive Use Of Ketaminementioning

confidence: 98%