Intraoperative care

Maintenance of anaesthesia can be achieved by inhaled volatile agents, continuous infusion of intravenous drugs (TIVA), or a combination of both techniques. During anaesthetic maintenance, it is important to ensure normovolaemia, taking into account pre-existing deficits and ongoing losses during surgery. In certain cases, special considerations regarding intraoperative blood glucose control should be taken (e.g. neonates). In specific situations, blood transfusion of red cells or other blood components may be necessary. Anaesthetists must be prepared to manage intraoperative problems such as hypoxia, airway obstruction, laryngospasm, bronchospasm, hypotension, massive haemorrhage, dysrhythmias, anaphylaxis, hypothermia, hyperthermia, and malignant hyperthermia. This chapter provides a simple and focused approach to dealing with these issues.