Complications of general anesthesia

complications GA

1. COMPLICATIONS OF GENERAL ANESTHESIA PROF. N K AGRAWAL JNMC,SAWNGI WARDHA INDIA

2. INDUCTION MUCSLE RELAXATION INTUBATION VENTILATION REVERSAL STEPS OF ANESTHESIA

3. The complication may be divided Intra operative Post operative

4. Due to - laryngoscopy - endotracheal tube Aspiration - secretions - blood Due to anesthetic drugs- hypoxia - hypotension/hypertension - hypercarbia/hypocarbia - hypothermia/hyperthermia INTRA OPERATIVE

5. Hypoglycemia/hyperglycemia Less or over fluid infusion Anemia Hyper thyrodism/ hypothyroidism IHD, MI Air embolism , fat embolism

6. TRAUMA TO LIPS TRAUMA TO TEETH TRAUMA TO TONGUE TRAUMA TO TONSILAR PILLAR TRAUMA TO EPIGLOTIES, VOCAL CORDS DUE TO LARYNGOSCOPY

7. Injury to vocal cords Injury to trachea Blockage of tube – secretions - blood clot - foreign body Branchospasm Due to endo tracheal tube

8. Low oxygen pressure Spo2- < 92 % Pao2-< 60 mm of hg Hypoxia

9. Normal ETCO2- 30 -42 mm hg > 50 mm Hg Hyper carbia

10. Systolic BP < 80 mm Hg 10 % fall in blood pressure from base line Hypotension

11. Fasting – 80-120 mg/dl Post meal- 120-180 mg/dl Normal blood sugar

12. Blood sugar < 60 mg/dl Hypoglycemia

13. Blood sugar > 200 mg/dl Hyperglycemia

14. Normal 98.4 f < 96 f Hypothermia

15. Maintenance- 2ml/kg/hr Intra operative- 4ml/kg/hr – 8ml/kg/hr Urine out put < 1ml/kg/hr Fluid infusion

16. Signs of retention of fluid edema over eyes Pulmonary edema

17. Anemia IHD MI

18. Inadequate reversal Laryngospasm Bronchospasm Meiosis Bradycardia Urine retention POST OPERATIVE

19. Aspiration Hypoxia Hypercarbia Hypo/hyperglycemia Hypotension Immediate

20. Hoarseness of voice Soar throat Cough Tracheities Tracheal stenosis Delayed

21. P A C -- DELAY SURGERY IF URI FEVER DM HT IHD MI HYPERTHYROIDISM HOW TO PREVENT ?

22. 4- 6 HOURS N B M

23. ANTI-PSILOGOGUS ANTI-EMETIC ANTI-HISTAMINIC ANTA-ACID ANALGESIC AMNESIA ADDITIVE PRE MEDICATION

24. PULSE BP SPO2 ETCO2 TEMPERATURE GLUCOSE ECG MONITORING

25. WAIT TILL PATIENT CAN BREATH ON ROOM AIR MINIMUM FOR 5 MIN CONCIOUS RESPONDING REGULAR RESPIRATION RRGULAR HR NORMAL BP POST OPERATIVE

26. KEEP IN I C U