Time-dependent Effects of Anesthetics on Systemic Stress Response

Anesthesia is an inevitable part of surgical care, especially under battlefield traumatic conditions. Emerging evidence shows that anesthesia can have effects on stress markers, independent of the underlying traumatic condition. Mechanistic understanding of the systemic stress response will lead to a better management of adverse effects and improved clinical outcomes. Total intravenous anesthesia (TIVA) has application in combat medicine because it accomplishes the goal of general anesthesia while decreasing the equipment necessary with the use of inhalation anesthetics. TIVA using ketamine and midazolam provides sedation, amnesia, analgesia in treating combat trauma patients. Understanding the effect of different anesthetic drugs on the systemic stress response is critical to nursing anesthesia care in advanced operations with limited access to physiological monitoring.