Articles: general-anesthesia.
-
Anasthesiol Intensivmed Notfallmed Schmerzther · Nov 2001
Review Comparative Study[Is measuring the depth of anesthesia sensible? An overview on the currently available monitoring systems].
Without any doubt there is an increasing need for accurately measuring depth of anesthesia - from the viewpoint of the anesthesiologist and also of the patient. The ideal monitoring should fulfill the following criteria: It should be applicable for any type of anesthesia (intravenous as well as inhalative anesthesia); the monitor must have an extremely high sensitivity (each patient being awake must be recognized by the device). If the monitor does not have a high sensitivity, the monitor itself might lead to an increasing number of patients being awake during anaesthesia, because the anesthesiologist might rely on the monitor and does not deepen anesthesia while the patient is awake. ⋯ They can only monitor the anesthetic state at the time of measurement. There is no "golden number" predicting absolutely safely that the patient is in adequate anesthesia. The anesthetist must consider any technique for monitoring of the depth of anesthesia as an additional help in improving care for his patient.
-
Effective management of the airway may have the greatest impact on mortality and morbidity of all pre-hospital interventions. The administration of a pre-hospital anaesthetic may not only facilitate effective management and protection of the airway but may also be fundamental to maintaining adequate ventilation and reducing times to definitive treatment for casualties who are trapped and those with major chest and head injuries. ⋯ Inappropriate attempts to anaesthetise critically injured casualties may prove fatal if the operator does not have the requisite knowledge, skills and equipment. For those that do, this article provides an operational framework within which pre-hospital anaesthesia can be developed (Box 5).