Advances in Anesthesia Delivery in the Deployed Setting

Area of Science:

• Anesthesiology
• Trauma Surgery
• Military Medicine

Background:

• Combat casualty management has evolved significantly over 15 years, influencing trauma anesthesia practices.
• Early deployable anesthesia relied on balanced techniques using volatile gases and IV adjuncts.
• Modern warfare demands mobile surgical capabilities with reduced logistical needs.

Purpose of the Study:

• To highlight the advantages of total intravenous anesthesia (TIVA) in deployed settings.
• To advocate for TIVA as a safe alternative for trauma management and resuscitation.
• To emphasize the need for future research and education on TIVA in austere environments.

Main Methods:

• Review of lessons learned in combat casualty management.
• Analysis of advancements in anesthesia equipment for deployed settings.
• Comparison of TIVA with volatile gas anesthesia in trauma care.

Main Results:

• Total intravenous anesthesia (TIVA) offers significant advantages for trauma management and resuscitation in deployed environments.
• Despite advancements in volatile anesthetic delivery, TIVA is recognized as a valuable alternative by experienced providers.
• The military's focus has been on lighter, more mobile volatile gas delivery systems.

Conclusions:

• TIVA presents a compelling option for anesthesia in austere combat environments.
• Future efforts in research, development, and education should prioritize TIVA.
• Adapting to future conflicts requires retaining lessons learned and innovating casualty management solutions.