COMPLICATIONS OF GENERAL

ANESTHESIA PROF. N K AGRAWAL

JNMC,SAWNGIWARDHA

INDIA

INDUCTION

MUCSLE RELAXATION

INTUBATION

VENTILATION

REVERSAL

STEPS OF ANESTHESIA

The complication may be divided

Intra operative

Post operative

Due to - laryngoscopy - endotracheal tube Aspiration - secretions - blood Due to anesthetic drugs- hypoxia -

hypotension/hypertension

- hypercarbia/hypocarbia -

hypothermia/hyperthermia

INTRA OPERATIVE

Hypoglycemia/hyperglycemia

Less or over fluid infusion

Anemia

Hyper thyrodism/ hypothyroidism

IHD, MI

Air embolism , fat embolism

TRAUMA TO LIPS

TRAUMA TO TEETH

TRAUMA TO TONGUE

TRAUMA TO TONSILAR PILLAR

TRAUMA TO EPIGLOTIES, VOCAL CORDS

DUE TO LARYNGOSCOPY

Injury to vocal cords

Injury to trachea

Blockage of tube – secretions - blood clot - foreign body Branchospasm

Due to endo tracheal tube

Low oxygen pressure Spo2- < 92 %

Pao2-< 60 mm of hg

Hypoxia

Normal ETCO2- 30 -42 mm hg

> 50 mm Hg

Hyper carbia

Systolic BP < 80 mm Hg

10 % fall in blood pressure from base line

Hypotension

Fasting – 80-120 mg/dl

Post meal- 120-180 mg/dl

Normal blood sugar

Blood sugar < 60 mg/dl

Hypoglycemia

Blood sugar > 200 mg/dl

Hyperglycemia

Normal 98.4 f

< 96 f

Hypothermia

Maintenance- 2ml/kg/hr

Intra operative- 4ml/kg/hr – 8ml/kg/hr

Urine out put < 1ml/kg/hr

Fluid infusion

Signs of retention of fluid

edema over eyes

Pulmonary edema

Anemia

IHD

MI

Inadequate reversal

Laryngospasm

Bronchospasm

Meiosis

Bradycardia

Urine retention

POST OPERATIVE

Aspiration

Hypoxia

Hypercarbia

Hypo/hyperglycemia

Hypotension

Immediate

Hoarseness of voice

Soar throat

Cough

Tracheities

Tracheal stenosis

Delayed

P A C --DELAY SURGERY IF

URI FEVER DM HT IHD MI HYPERTHYROIDISM

HOW TO PREVENT ?

4- 6 HOURS

N B M

ANTI-PSILOGOGUS ANTI-EMETIC ANTI-HISTAMINIC ANTA-ACID ANALGESIC AMNESIA ADDITIVE

PRE MEDICATION

PULSE BP SPO2 ETCO2 TEMPERATURE GLUCOSE ECG

MONITORING

WAIT TILL PATIENT CAN BREATH ON ROOM AIR MINIMUM FOR 5 MIN

CONCIOUS RESPONDING REGULAR RESPIRATION RRGULAR HR NORMAL BP

POST OPERATIVE

KEEP IN I C U