Journal of Anaesthesiology Clinical Pharmacology (Jan 2019)

Anesthetic considerations for extracranial injuries in patients with associated brain trauma

  • Ankur Khandelwal,
  • Parmod Kumar Bithal,
  • Girija Prasad Rath

DOI
https://doi.org/10.4103/joacp.JOACP_278_18
Journal volume & issue
Vol. 35, no. 3
pp. 302 – 311

Abstract

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Patients with severe traumatic brain injury often presents with extracranial injuries, which may contribute to fatal outcome. Anesthetic management of such polytrauma patients is extremely challenging that includes prioritizing the organ system to be dealt first, reducing on-going injury, and preventing secondary injuries. Neuroprotective and neurorescue measures should be instituted simultaneously during extracranial surgeries. Selection of anesthetic drugs that minimally interferes with cerebral dynamics, maintenance of hemodynamics and cerebral perfusion pressure, optimal utilization of multimodal monitoring techniques, and aggressive rehabilitation approach are the key factors for improving overall patient outcome.

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