Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-27T07:27:27.192Z Has data issue: false hasContentIssue false
  • English
  • Français

Methods of Anesthesia under Shock Conditions

Published online by Cambridge University Press:  17 February 2017

A. Madjidi  and
Rudolf Frey
A. Madjidi
Affiliation:
Institute of Anesthesiology, University of Mainz, West Germany
Rudolf Frey
Affiliation:
Institute of Anesthesiology, University of Mainz, West Germany
Get access Rights & Permissions [Opens in a new window]

Extract

The use of anesthesia in patients in shock is associated with many problems and considerable risk. This is particularly true when only little time is available for adequate pretreatment because surgical intervention is urgent. In choosing a method of anesthesia for patients in shock, knowledge of the pathophysiology and treatment is of utmost importance.

Le Dran first introduced the term “Shock” (French translation: “commotion”) to the medical nomenclature. The term has undergone alteration in later usage. In 1795, Latta defined shock as the condition arising from serious war injuries resulting from bullet wounds. He was the first to describe shock as “a short sojourn along the way to death.” During the First World War and the postwar period, the role of intra vascular volume deficiency in shock was clarified. Experience gained during the 1939-45 World War and the Korean War, together with the increased civilian accident rate, and research in the field of anesthesiology have led in recent years to considerble clarification of both pathogenetic and the therapeutic aspects. Today, shock can be defined as an acute reduction in tissue perfusion with consequent tissue hypoxia and metabolic acidosis, regardless of the causative factor.

The organs are first functionally and then morphologically damaged. Four mechanisms can be involved in shock; 1) reduction of the volume of blood in circulation (hypovolemic shock); 2) disturbances of the vascular system (vascular shock, anaphylactic and toxic shock); 3) reduction in the functional capacity of the heart (cardiogenic shock); and 4) intrathoracic circulation impediment (shock emboli).

Type
Section Three—Definitive Medical Care
Information
Prehospital and Disaster Medicine , Volume 1 , Issue 2 , Summer 1985 , pp. 171 - 172
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 Ahnefeld, FW, Frey, R, Halmagyi, M. Verhütung und Behandlungdes Schocks in den operativen Fachern. Internist 1962; 543–549.Google Scholar
2 Allgower, M. Schock. In, Lehrbuchder Chirurgie. Heller, Nissen, Vosschulte, . Stuttgart: G. Thieme Verlag, 1958.Google Scholar
3 Duesberg, R, Schröder, W. Pathophysiologie und Klinik der Kollapszustände. Leipzig:Hirzel, 1944.Google Scholar
4 Gersmeyer, EF, Yasagil, EC. Kreislauf-zentralisation. In Schock und Kollapsfibel. Stuttgart: G. Thieme Verlag, 1970.Google Scholar
5 Just, OH. Genese und Therapie des haemorrhagischen Schocks. Stuttgart: Thieme Verlag, 1966.Google Scholar
6 Latta, I. A practical system of surgery. Vol II, chap 12. Edinburgh: Mudie, 1795.Google Scholar
7 Le Dran, HF. Treatise or reflections, drawn from practise on gunshot wounds. Übersetzt aus dem Franzosischen. London: Clarke, 1743.Google Scholar
8 Messmer, KL, Sunder-Plassmann. Möglichkeiten und Grenzen Therapeutischer Haemodilution. Vortrag Symposion Krems, 1969.Google Scholar
9 Shoemaker, WC. Schock, Chemistry, Physiology. 3rd Ed. Philadelphia: W.B. Saunders, 1966.Google Scholar