Complications of anesthesia

Anesthesia can be associated with a number of complications. Complications are associated with the technique of anesthesia or with the specificity of the action of narcotic drugs on vital organs and systems. In the initial stage of anesthesia, vomiting often occurs, which can occur as a result of the action of the drug on the vomiting center or due to the presence of various pathologies: the pyloric stenosis, intestinal obstruction. Vomiting can lead to aspiration, that is, the ingestion of gastric contents into the trachea and bronchi. Gastric contents with a pronounced acidity can cause laryngospasm and bronchospasm. All this leads to a violation of breathing and hypoxia.

In the course of anesthesia, regurgitation can also occur, which can be caused by deep anesthesia, the use of muscle relaxants, a decrease in sphincter tension, and excessive contents of the stomach cavity. Regurgitation is the passive throwing of gastric contents into the trachea and bronchi. Often, vomiting and regurgitation subsequently lead to the development of severe pneumonia, sometimes with a fatal outcome.

To prevent vomiting and regurgitation, it is necessary to rinse the stomach before anesthesia and put a cleansing enema. Before the beginning of the operation, it is recommended to use the device when the doctor presses on the cricoid cartilage posteriorly for the squeezed esophagus. If nevertheless there was a vomiting or a regurgitation, the gastric contents should be quickly evacuated by means of suction. After exiting from anesthesia, patients often also vomit, to prevent the patient is laid horizontally, and the head is turned to the side, the patient should be observed by the nurse.

Complications from the respiratory system may occur if the airway is obstructed. Such complications can be associated with a malfunction of the anesthesia apparatus, the rooting of the root of the tongue with deep anesthesia, the ingress of foreign objects into the respiratory tract( teeth, prostheses).For preventive maintenance before operation it is necessary to check up an anesthesia apparatus condition, its tightness and gas passage on respiratory tubes. It is necessary to carefully examine the oral cavity and before the operation remove the false teeth and prostheses. Against the backdrop of deep anesthesia, the patient is jawed forward so that his tongue does not fall.

With tracheal intubation, which is performed by direct laryngoscopy, it is also possible to develop various complications. These include traumatizing teeth with a laryngoscope blade, traumatizing the vocal cords, getting the intubation tube into the esophagus, in the right bronchus, kinking of the endotracheal tube, or exiting the trachea. All these complications can be avoided if the doctor has a perfect knowledge of intubation technique, when monitoring the position of the intubation tube in the trachea over her bifurcation with the auscultation of the lungs during intubation.

Complications of the cardiovascular system. A sharp drop in blood pressure may occur at the beginning or during anesthesia. Hypotension may occur as a result of the effects of narcotic drugs on the activity of the heart or on the vasomotor center. This complication can occur with an overdose of narcotic substances, for example, fluorotan. Hypotension also occurs in patients with low BCC( volume of circulating blood).In order to prevent hypotension before performing surgical interventions, replenishment of the circulating fluid volume is performed, if operative intervention is accompanied by abundant blood loss, it is necessary to complete the BCC during the operation itself, for this, blood-substituting drugs are introduced.

Often during anesthesia, heart rhythm disturbances occur( ventricular tachycardia, ventricular fibrillation, extrasystole).This may lead to hypoxia or gynercapnia, they occur with prolonged intubation or insufficient ventilation of the lungs. Also, hypercapnia and hypoxia leads to an overdose of barbiturates, ftorotan, the use of adrenaline with ftorotanum, which increases the sensitivity of fluorotan to catecholamines.

To monitor the heart rhythm of the patient during the operation, electrocardiographic monitoring is necessary. Treatment of rhythm disturbance is carried out depending on the cause that caused this complication, elimination of hypoxia, reduction of the dose of the drug.

In case of insufficient assessment of the patient's condition, if anesthesia, hypoxia, hypercapnia are wrongly performed, the most serious complication is possible - cardiac arrest. In this case, urgent cardiopulmonary resuscitation is necessary.

Hypothermia may occur during anesthesia. The reason for this is the effect of narcotic drugs on the centers of thermoregulation or hypothermia of the patient. The organism of the patient after hypothermia tries to restore body temperature due to the enhancement of metabolism. Therefore, at the end of anesthesia and in the postoperative period of patients, chills worry. Chills often occur after anesthesia with fluorotane. To prevent hypothermia of the patient, it is necessary to control the temperature in the operating room, it must keep within 21-22 ° C, the patient must be covered, all infusion drugs administered to the patient must be pre-heated to body temperature, and the patient's body temperature should be monitored.

Another formidable complication is cerebral edema. Cerebral edema can occur with prolonged and profound hypoxia during anesthesia. Treatment of this complication is started immediately, using methods of dehydration, hyperventilation, local complication of the brain.

With a strong hand from the body of the patient, throwing back the arm, that is, if the patient is lying incorrectly on the operating table, this can lead to traumatization of the peripheral nerves. This complication manifests itself in a day or more after anesthesia. The nerves of the upper and lower extremities suffer more often, the brachial plexus. Neurologists and physiotherapists treat peripheral nerve damage. To prevent the development of complications, it is necessary to monitor the correct position of the patient on the operating table.