Hostname: page-component-84b7d79bbc-2l2gl Total loading time: 0 Render date: 2024-07-28T21:03:12.850Z Has data issue: false hasContentIssue false
  • English
  • Français

Continuous Infusion of Ketamine and Althesin for Anesthesia in Disaster Situations

Published online by Cambridge University Press:  17 February 2017

E. Bisio ,
J. Zattoni ,
C.D. Roccatagliata ,
M.R. Germi  and
P. Fuccaro
E. Bisio
Affiliation:
Center of Anesthesiology, University of Ulm, West Germany
J. Zattoni
Affiliation:
Institute of Anesthesiology and Intensive Care Medicine, University of Genoa, Genoa, Italy
C.D. Roccatagliata
Affiliation:
Institute of Anesthesiology and Intensive Care Medicine, University of Genoa, Genoa, Italy
M.R. Germi
Affiliation:
Institute of Anesthesiology and Intensive Care Medicine, University of Genoa, Genoa, Italy
P. Fuccaro
Affiliation:
Institute of Anesthesiology and Intensive Care Medicine, University of Genoa, Genoa, Italy
Get access Rights & Permissions [Opens in a new window]

Extract

Traffic, industrial or natural disasters and wars frequently threaten the lives of a large number of victims. Often the patients suffer a combination of injuries to the head, extremities, thorax, lung and abdomen. Immediate anesthetic measures at the site of the accident are required and essential to the survival of the patients with multiple injuries. During transport, further surgical and anesthetic treatment may also be needed. Occasionally, the number of people involved in a disaster exceeds the treatment capacity of the nearby medical institutions. Urgent and improvised decisions are required with a clear picture of the treatment resources at the site of the accident or during transport.

Special attention must be focused on necessary surgical measures and intensive care, as well as resuscitation and advanced anesthetic expertise — essential pillars of support. In many cases, the anesthetic treatment of patients with multiple injuries is the decisive therapeutic measure. The anesthetic technique must be guided by the pathophysiological requirements. The medications used should have a controllable and pronounced hypnotic-sedative and analgesic effect, without having a depressant influence on respiration or circulation, and they should improve organ perfusion. Furthermore, they should provide a means for cerebral protection. The anesthetic apparatus should be simple and compact and it should be possible to apply the technique over several hours, using room air, with or without the addition of oxygen. The agents and apparatus should be compatible with the use of every type of muscle relaxant and narcotic. New intravenous anesthetic agents meet these criteria.

Type
Section Three—Definitive Medical Care
Information
Prehospital and Disaster Medicine , Volume 1 , Issue 2 , Summer 1985 , pp. 176 - 179
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1985

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Chacornac, R, et al. Emploi du CT 1341 en neurochirurgie. Ann Anesth Franc 1973; 14:565.Google Scholar
2 Dick, W, et al. Ketamin: Anästhesiologie und Wiederbelebung, Bd. 69. New York:Springer, 1973.Google Scholar
3 Gobiet, E, Bock, WI. Der Cerebrale Perfusionsdruck. Der Anästhesist 1974; 23:253.Google Scholar
4 Hatano, S, et al. Ketamine-Diazepam anaesthesia for abdominal surgery. (A review of 1000 cases with continuous “micro-drip” mini administration-technique). Der Anästhesist 1978; 27:172.Google Scholar
5 Knoche, E, Traub, E, Dick, W. Möglichkeiten der medikamentösen Beeinflussung von unerwünschten Nebenwirkungen und Aufwachreaktionen nach Ketamin-Anästhesie. Der Anästhesist 1978; 27:302.Google Scholar
6 Kreuscher, H. Erfahrungen mit der Tranquanalgesie. Erlanger Anästhesie-Seminare (Rügheimer E, 1, 46, 1977). Bubenreuth:Medizin-Media-Analyse (1977).Google Scholar
7 Marshall, LF, et al. The outcome with aggressive treatment in severe head injuries Part II: Acute and chronic barbiturate administration in the management of head injury. J Neurosurg 1979; 50:26.CrossRefGoogle ScholarPubMed
8 Savege, TM, et al. The cardiorespiratory effects of Althesin and Ketamine. Anesthesia 1973, 28:391.CrossRefGoogle ScholarPubMed
9 Siesjo, BK, et al. Effects of increased CSF pressure upon lactate and pyruvate in rat brain tissue. Acta Neurol Scand 1972; 46:187.Google Scholar
10 Sari, A, et al. Effects of Althesin on cerebral blood flow and oxygen consumption in man. Brit J Anaesth 1976; 48:545.Google Scholar
11 Tarnow, J. Hess, W. Flunitrazepam-Vorbehandlung zur Vermeidung kardiovaskulärer Nebenwirkungen von Ketamin. Der Anästhesist 1979; 28:468.Google Scholar
12 Zaffiri, O, et al. Anesthesia problems presented by subjects with multiple injuries. Min Anesth 1980; 46:173.Google Scholar
13 Turner, JM, et al. The effect of Althesin on intracranial pressure in man. Brit J Anaesth 1973; 45:168.CrossRefGoogle ScholarPubMed
14 Zattoni, J, et al. Effects of some anesthetic drugs on the ventricular fluid and blood pressure, both arterial and venous. In, Brock, M, Dietz, H (eds.). Intracranial Pressure. New York: Springer, 1972.Google Scholar
15 Zattoni, J, et al. Effects of Enflurane on ICP and indications for its use in intracranial surgery. J Neurosurg 1976; 20:243.Google Scholar