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Chapter 13 - Under Pressure

TIVA in Emergency Surgery

Published online by Cambridge University Press:  18 November 2019

Michael G. Irwin
Affiliation:
The University of Hong Kong
Gordon T. C. Wong
Affiliation:
The University of Hong Kong
Shuk Wan Lam
Affiliation:
The University of Hong Kong
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Summary

At some time during one’s practice in anaesthesiology, one cannot help but notice certain obsessive–compulsive tendencies in our colleagues. Such traits are quickly revealed when you put them under pressure by asking them to do an unplanned emergency case and disrupt the cocoon that is their elective list. In contrast to having known and prepared for all of the patient’s problems, they are now compelled to deal with a relatively unknown and often sub-optimal situation. More likely than not, they will have to induce anaesthesia with rapid sequence induction (RSI). Whereas some may be thrilled, others are less impressed with the disorder introduced into their world. What is it about emergency cases that should be such a bother? In particular, can TIVA enthusiasts thrive in this environment? At the time of writing, the use of TIVA in emergency is indeed somewhat uncharted territory as very few studies have examined this area.

Type
Chapter
Information
Taking on TIVA
Debunking Myths and Dispelling Misunderstandings
, pp. 106 - 110
Publisher: Cambridge University Press
Print publication year: 2019

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References

Perlas, A., Chan, V.W., Lupu, C.M., Mitsakakis, N., Hanbidge, A.. Ultrasound assessment of gastric content and volume. Anesthesiology 2009; 111: 82–9.Google Scholar
Gagey, A.C., de Queiroz Siqueira, M., Monard, C., et al. The effect of pre-operative gastric ultrasound examination on the choice of general anaesthetic induction technique for non-elective paediatric surgery. A prospective cohort study. Anaesthesia 2018; 73: 304–12.Google Scholar
Mendelson, C.L.. The aspiration of stomach contents into the lungs during obstetric anesthesia. Am J Obstet Gynecol 1946; 52: 191205.Google Scholar
Patel, A., Nouraei, S.A.. Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE): a physiological method of increasing apnoea time in patients with difficult airways. Anaesthesia 2015; 70: 323–9.Google Scholar
Slupe, A.M., Kirsch, J.R.. Effects of anesthesia on cerebral blood flow, metabolism, and neuroprotection. J Cereb Blood Flow Metab 2018; 38: 2192–208.Google Scholar
Johnston, A.J., Steiner, L.A., Chatfield, D.A., et al. Effects of propofol on cerebral oxygenation and metabolism after head injury. Br J Anaesth 2003; 91: 781–6.Google Scholar
Fan, W., Zhu, X., Wu, L., et al. Propofol: an anesthetic possessing neuroprotective effects. Eur Rev Med Pharmacol Sci 2015; 19: 1520–9.Google ScholarPubMed
Grathwohl, K.W., Black, I.H., Spinella, P.C., et al. Total intravenous anesthesia including ketamine versus volatile gas anesthesia for combat-related operative traumatic brain injury. Anesthesiology 2008; 109: 4453.Google Scholar
Van Keer, L., Van Aken, H., Vandermeersch, E., Vermaut, G., Lerut, T.. Propofol does not inhibit hypoxic pulmonary vasoconstriction in humans. J Clin Anesth 1989; 1: 284–8.Google Scholar
Mushambi, M.C., Kinsella, S.M., Popat, M., et al. Obstetric Anaesthetists’ Association and Difficult Airway Society guidelines for the management of difficult and failed tracheal intubation in obstetrics. Anaesthesia 2015; 70: 1286–306.Google Scholar
Van de Velde, M., Teunkens, A., Kuypers, M., Dewinter, T., Vandermeersch, E.. General anaesthesia with target controlled infusion of propofol for planned caesarean section: maternal and neonatal effects of a remifentanil-based technique. Int J Obstet Anesth 2004; 13: 153–8.Google Scholar

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