Perioperative Anaesthesia Management

Anaesthesia maintenance uses remifentanil and propofol via target-controlled infusion alongside cisatracurium. Bispectral Index is maintained at 40–60 during anaesthesia maintenance. Additional perioperative drugs include dexamethasone after induction and azasetron before the end of surgery. Neuromuscular blockade reversal with neostigmine and atropine is administered once three responses to train-of-four stimulation are observed. Resource limitations led clinicians to assess anaesthesia depth using clinical and subjective monitoring signs. Anaesthesia induction used intravenous ketamine and propofol or inhalational halothane. All airway management used oral endotracheal intubation rather than laryngeal mask airways. Post-intubation mechanical ventilation mode was chosen according to pulmonary status. All extubations in the trial are performed while patients are awake.