Artificial coma after cardiac arrest and resuscitation
In the event of cardiac arrest, the brain and all other organs are severely deprived of oxygen within a few minutes. The brain reacts quickly to a lack of oxygen with an inflammatory reaction, which includes swelling. Since there is little room for swelling in the skull, this leads to increased intracranial pressure and further damage to the brain.
To prevent this reaction, an artificial coma is possible. The oxygen supply can be secured and the stress for the body reduced. In an artificial coma, the cerebral pressure can also be continuously controlled with a probe.
If the reason for the cardiac arrest is not known, further examinations can be carried out during this time. The time of awakening and also the later state of health is strongly dependent on how long the brain had to get along without oxygen. In the case of direct resuscitation in hospital, the consequential damage is usually less than in the case of patients who suffer a cardiac arrest at home and have waited for the rescue service. Here, cardiopulmonary resuscitation by relatives is very important. The rescue service often induces anaesthesia on the spot in order to protect the body of the affected person and to control the body functions.
Which medications maintain the artificial coma?
The artificial coma is basically a normal general anaesthetic. It consists of drugs that reduce consciousness, pain sensation and muscle function. Propofol is usually used to limit consciousness.
Pain reduction is achieved with opiates such as morphine, fentanyl or sufentanyl. Relaxing drugs such as succinylcholine are used for muscle function. In contrast to short-term anaesthesia, medication is normally administered through the veins and no additional anaesthetic gas is used.
Cramps
During the artificial coma, cramps are rare, since muscle work is also influenced and suppressed by medication. More critical in an artificial coma is the wake-up phase.The body has to relearn its normal functions, including muscle control, and this can lead to excessive reactions. Furthermore, many powerful drugs have an influence on brain function and can cause cramps.
In addition there is the basic illness, which can be for example an undersupply or injury of the brain. The anaesthetic drugs can suppress cramps, so that these can only occur in the wake-up phase when weaning off the drugs.
