Key result
In a deployed military setting, regional anesthesia was the predominant technique, used alone in 43.5% of cases and combined with general anesthesia in 21% of cases.
Why the study?
Military anesthesia involves unique logistical, technical, tactical, and human constraints, but limited data have been published on anesthesia management during military operations.
Observational (n=1,547)
No
In austere military deployment environments, regional anesthesia is significantly preferred over general anesthesia for common surgeries compared to standard hospital practice.
Regional anesthesia feasibility in austere settings may guide military protocols; leaves open comparative outcomes versus general anesthesia.
BACKGROUND: Military anesthesia meets unique logistical, technical, tactical, and human constraints, but to date limited data have been published on anesthesia management during military operations. OBJECTIVE: This study aimed to describe and analyze French anesthetic activity in a deployed military setting. METHODS: Between October 2015 and February 2018, all patients managed by Sainte-Anne Military Hospital anesthesiologists deployed in mission were included. Anesthesia management was described and compared with the same surgical procedures in France performed by the same anesthesia team (hernia repair, lower and upper limb surgeries). Demographics, type of surgical procedure, and surgical activity were also described. The primary endpoint was to describe anesthesia management during the deployment of forward surgical teams (FST). The secondary endpoint was to compare anesthesia modalities during FST deployment with those usually used in a military teaching hospital. RESULTS: During the study period, 1547 instances of anesthesia were performed by 11 anesthesiologists during 20 missions, totaling 1237 days of deployment in nine different theaters. The majority consisted of regional anesthesia, alone (43.5%) or associated with general anesthesia (21%). Compared with France, there was a statistically significant increase in the use of regional anesthesia in hernia repair, lower and upper limb surgeries during deployment. The majority of patients were civilians as part of medical support to populations. CONCLUSION: In the context of an austere environment, the use of regional anesthesia techniques predominated when possible. These results show that the training of military anesthetists must be complete, including anesthesia, intensive care, pediatrics, and regional anesthesia.
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Mathais et al. (2019) conducted an observational in Patients requiring surgery in a deployed military setting (n=1,547). Anesthesia management in a deployed military setting vs. Anesthesia management in a French military teaching hospital was evaluated on Description of anesthesia management modalities during deployment (proportion of regional anesthesia alone). In a deployed military setting, regional anesthesia was the predominant technique, used alone in 43.5% of cases and combined with general anesthesia in 21% of cases.
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