Maintenance of anaesthesia

Abstract

Key goals for the maintenance phase of general anaesthesia are the provision of surgical anaesthesia while maintaining physiological parameters at levels that preserve organ function and avoid injury. Maintenance can be achieved with either inhaled or intravenous anaesthetic agents. A good understanding of the physiochemical properties of these agents is necessary for effective manipulation of depth of anaesthesia at any stage. Drugs suitable for total intravenous anaesthesia are mainly those with short context-sensitive half-times, such as propofol, remifentanil, and dexmedetomidine. Target-controlled infusion pumps utilize three-compartment models in complex calculations to achieve the desired effect-site concentration. Monitoring during anaesthesia has been proven to reduce risk in the perioperative period. Sustained vigilance and good exchange of information at handover between anaesthetists are other essential aspects of safe anaesthesia during the maintenance phase.