Anesthetic considerations in damage control surgery.
The damage control patient is a special subset of the acute trauma population that presents unique challenges for every clinician involved. Communication between team members is critical, but the knowledge of and respect for each other's role lead to prompt, cost-efficient, high-quality care. The anesthesiologist's early goal is control of the airway and prevention of airway catastrophes by early recognition of the difficult airway. The introduction of airway adjuncts such as the laryngeal mask airway and esophageal Combitube has given trauma teams additional options in an airway crisis. Recent insights into the physiologic effects of the intra-abdominal compartment syndrome have improved anesthetic care as well. Ongoing developments in pain management help to improve patient comfort and outcome. By using available therapeutic modalities, as well as serving as a team manager and communications expert, the anesthesiologist provides added value to clinical care during damage control surgery.