Abstract
Abstract
High altitude has direct deleterious effects on human physiology and induces compensatory changes that must be considered when performing anesthesia. And, if not calibrated, anesthetic equipment can malfunction. The body responds to decreased atmospheric oxygen with increased heart rate, blood pressure, minute ventilation, and red blood cell production. Symptoms of high-altitude sickness may include those of hypoxia, pulmonary edema, and central nervous system irritation. Treatment for high-altitude sickness relies on descent. When anesthesia at high altitude is contemplated, there are several important considerations. Medications that reduce respiratory drive should be used only judiciously. Supplemental oxygen should be used liberally. Regional anesthesia and total intravenous anesthesia are good choices because they are relatively unaffected. An inhalational technique should avoid nitrous, and care should be taken to assess gas vaporizers for compensation. Trapped air in the body or medical equipment will expand with rapid ascent and should be planned for in the event of aeromedical evacuation.
Publisher
Oxford University PressNew York
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