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Anesthetic Considerations in Patients with Gas Gangrene

MICHAEL J. LAFLIN, LT^*, RAYMOND E. TOBEY, CAPT, and J. G. REVES, LCDR

*Resident, Department of Anesthesiology, National Naval Medical Center, Bethesda, Maryland 20014. Director, Division of Experimental Anesthesiology and Pharmacology, Naval Medical Research Institute, Bethesda. Staff Anesthesiologist, Department of Anesthesiology, National Naval Medical Center.

Abstract

Anesthesia for a patient with gas gangrene presents a challenge for the anesthesiologist, since it is an uncommon disease requiring emergency treatment. The authors, faced with such a challenge and finding little guidance in the literature, have proposed modalities of anesthetic management based on pathophysiology, symptomatology, and the reported experience of others. In addition to choice of anesthetic agents, problems reviewed include shock, hypovolemia, tachycardia, fever, anemia, renal dysfunction, pulmonary insufficiency, and contamination. Factors relating to anesthesia during hyperbaric-O₂ therapy are also reviewed.