Complications Of Gen.

Anesthesia
hamed abedalnabi flaifel
March 2012

Respiratory- 1
complications
Cardiovascular -2
complications
Gastrointestinal- 3

Neurological-4
complications
Complications from- 5
posture
Miscellaneous-6
complications
Hazards
to medical & nursing staf

Complications of
anesthesia

Respiratory complications- 1
a-Upper airway obstruction:
causes( soft tissuses, foreign body,
laryngeal spasm(endotracheal
tube,oxygen supply)

b- Bronchospsm, c-Cough, d-Hiccup, eAtelactasis

f-Aspiration Pneumonitis (
Mendelson Syndrome), g- Pulmonary
,Barotraumas
h-Sleep apnea ,
iDVT&Pulm.Embolism

Cardiovascular
complications
Cardiac dysrhythemias- 1
;causes( cardiac pathology,
hypoxia,hypercapnia, malignant
hyperthermia, adrenaline,electrolytes
disturbances)
Myocardial infarction, ischemia
-2
3-Stroke (atrial fibrillation,
neck rotation causing vertebral artery
obstruction )

hypertension at immediate- 4
postoperative period (pain , full
bladder,undiagnosed
hypertension)
air or gass embolism-5
a-surgical(injured veins above
heart level)
b- therapeutic, diagnostic

Gastrointestinal
complications

postoperative nausea&vomiting PONV

-1

factors( patient, anesthetic

technique, stomach, operation
Treatment & prevention
Prochloperazine 12.5 mg,im, cyclizine 50
mg ,metoclopromide 10 mg,domperidone
10 mg droperidol 1-5mg ,hyoscine
0.4mg , ,clonidine ,ONDANSETRONE 4-8
mg ;IM,IV

Intraoperative
vomiting(active),regurgitation(pas
sive)
Laryngeal spasm
-1
2-Lung aspiration of gastric contentsresults :
i-mild (reflex bradycardia/atelactasis
/bronchopneumonia/ lung abscess ;onset 2-10 days, xray ; patch of consolidation, fluid level
treatment
;postural drainage,antibiotic
ii-Moderate-sever- Mendelson syndrome
Increase risk when volume > 25 mls/ pH < 2.5; ONSET
immediately -few hours , signs /symptoms
(CyanosisDyponea,Bronchospsm,Hypotension,tachycard
ia,crakles,wheezing,sever plum. Edema ,death / chest
x-ray : irregular mottled densities

PREVENTION OF ACID ASPIRATION

SYNDROME(MENDELSON SYNDROME)
avoid heavy preoperative sedation- 1
2-ensure empty
stomach
(tube,drugs;metoclopromide,apomor
phine ) 3- H2 receptor antagonist
ranitidine 150 mg P.O ; night +
morning of operation .
4neutralization of gastric acid ;Na.
citrate 15-30 mills of 0.33 moles

rapid sequence induction of- 5

anesthesia
preoxygination 100 % O2, for at-
least 3 minutes
,
IV induction ,suxamethonium-
Sellick maneuver;(cricoid pressure40
newtons , extension of the neck with
hand support)
endotracheal intubation-

awake intubations- 6
topical analgesia for upper -
airways ,
- fibreoptic
endoscopy
extubation in the lateral position-
reagional

block-7

TREATMENT OF ACID
ASPIRATION
prevention further aspiration by tilting-1
head downward or turning the patient to
one side2 use suction 3 give oxygen,
4-tracheal tube suction5-bronchposcopy
6- bronchodilator7-antibiotic,8physiotherapy-9- steroid is not
recommended

NEUROLOGICAL-4
COMPLICATIONS
abnormal muscle twitching &convulsion causes (propofol,
halothane),epilepsy, preclampsia

DELAYED RECOVERY DURING

ANESTHESIA

drugs overdose-1
disturbance of physiology from -2
anesthesia,
hypoxia,hypercapnia,electrolytes and
acid base
disturbances,hypotension,hypothrmi
a
Disturbances from surgery;-3
hemorrhage,fat embolism,air

patients diseases

-4

Cerebrovascular disease,
myocardial
ischemia,myxoedema,hypopituiterism,hy
poglycemia, hyperglycemic coma,adrenal
insufficiency, uremia, liver failure,
undiagnosed brain tumour

Drugs taken before operation -5

MAOI (MONO AMINNE OXIDASE
INHIBITORS) taken before operation
interacts with pethidine or sedatives
given intra- or postoperatively

Central anti cholinergic syndrome - 6

.
after hyoscine
.treated by physostigmine 1-2 mg

septicemia presenting early in- 7

postoperative period
..

COMPLICATIONS FROM POSTURE-5

Trendelenburg position ; prolong
cerebral edema,retinal detachement
prone position ;
corneal abrasion,retinal artey
occlusion &blindness from pressure
on eyes lithotomy position; stain on
pelvic ligaments ,streching of sciatic
nerves by deep flexion of hips

Supine position - ulnar nerve injury

at elbow ( pading +supination)pading of ankles to protect Achillis
tendon ,prevent DVT

miscellaneous -6
complications
awareness during GA,
hallucinations ,malignant
hyperthermia, scoline apnea ,
halothane hepatitis , anaphylaxis,
trauma to the airways ,teeth ,
thrombophlebitis

Hazards to medical &

nursing staf
pollution of air ; abortion, reduced-
fertility - stress ; suicide, addiction
- blood borne
viruses
hepatitis, AIDS