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J Anaesthesiol Clin Pharmacol. 2019 Jul-Sep;35(3):302-311. doi: 10.4103/joacp.JOACP_278_18.

Anesthetic considerations for extracranial injuries in patients with associated brain trauma.

Author information

1
Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
2
Department of Anesthesia and OR Administration, King Fahad Medical City, Riyadh, Saudi Arabia.

Abstract

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.

KEYWORDS:

Anesthesia; extracranial injury; intracranial pressure; traumatic brain injury

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