How anaesthetic drugs are selected to account for patient and surgical factors: A case report.

Abstract

The patient's health and nature of the surgery are important considerations when selecting anaesthetic drugs. This report considers the anaesthetic drugs selected for a patient undergoing day case diagnostic laparoscopy for chronic pelvic pain. Appropriate drug selection for patients with a suspected history of cancer is crucial. Anaesthetic agent selection requires a balance between possible postoperative complications and long-term survival. Total intravenous anaesthesia was selected for its favourable long-term survival rate, its effect on reducing immunosuppression, and to aid with providing a bloodless field. Metaraminol was selected to prevent profound hypotension and to provide normotension when assessing bleeding. Sugammadex has a high binding affinity for steroidal hormones, potentially contributing to contraceptive failure. Neostigmine was selected as the reversal agent due to the childbearing age of the patient. A muscle relaxant was selected to improve surgical conditions via a pneumoperitoneum. Rocuronium was selected due to its rapid onset and rapid reversibility with sugammadex. A thorough understanding of anaesthetic drugs is required if they are to be used appropriately. Inappropriate anaesthetic drug selection may provide sub-optimal operating conditions, contribute to unplanned pregnancy, worsen patient outcomes, and delay discharge.