Atuação do anestesista e estratégias anestésicas no manejo inicial do trauma na urgência e emergência

Abstract

Considering that trauma remains a leading cause of death and disability and requires immediate decisions to prevent secondary injury, this study analyzed the role of the anesthesiologist and the anesthetic strategies used in the initial management of trauma patients in urgent and emergency care. An integrative literature review was conducted in PubMed/MEDLINE, SciELO, and Google Scholar, prioritizing publications from 2015 to 2026 while retaining classic studies and highly relevant guidelines. The qualitative synthesis showed that the anesthesiologist's contribution spans the entire initial response, including systematic assessment, airway control, rapid sequence intubation, ventilation, analgesia, monitoring, and hemostatic resuscitation. Difficult-airway protocols, physiological optimization before intubation, individualized drug selection, early hemorrhage control, prevention of hypothermia and coagulopathy, and structured team communication emerged as key safety measures. The review also showed that neither a single technique nor one induction agent is universally superior. It is concluded that improved care depends on decisions tailored to the patient's physiology, available resources, multidisciplinary training, and the early integration of the anesthesiologist into the trauma system.