Stomach content entering the lungs is referred to as aspiration and the inflammation within the tissue it causes is referred to an aspiration pneumonitis. If an infection were to develop in the inflamed area of the lungs following an aspiration event, this is known as aspiration pneumonia. The risk of an aspiration event is higher in certain patients. These patients include people with moderate to severe reflux, those who have eaten within the previous hours, pregnant women, and diabetic patients whose stomachs do not empty properly.
Anesthesiologists can attempt to reduce the risk of aspiration by administering medications that enhance gastric emptying speed up the movement of food from the stomach into the intestines or increase the pH of the gastric contents make them less acidic, and therefore less damaging to lung tissue. They may also apply cricoid pressure pressure on the cartilage of your trachea or windpipe during intubation placement of an endotracheal tube.
Theoretically, this pressure can compress the esophagus food pipe and prevent regurgitation during manipulation of the airway. Peripheral nerve damage can occur with any type of surgery and is the result of nerve compression. It is most commonly caused by extensive periods of time in an exaggerated or awkward position. The ulnar nerve of the arm runs along the little finger side of the forearm and the peroneal nerve of the lower leg runs along the outside of the leg between the knee and ankle are affected most often.
The severity of damage and recovery of function are variable and may be prolonged. Both the anesthesiologist and surgeon are aware of this potential complication and take steps to prevent it. When possible, extreme postures are avoided and the body placed in a neutral position. Padding is placed under pressure points, particularly the elbows, hips, knees, heels, and any other dependent body region during patient positioning. These pressure points are reassessed throughout the procedure to ensure the padding and body is properly positioned.
If nerve damage is suspected post-operatively, the patient is followed up and may be referred for further testing, such as electromyography. Complications from regional anesthesia or nerve blocks have been reduced with the utilization of ultrasound-guided placement.
Because all nerve blocks require the use of needles, there is always the potential for bleeding, hematoma formation, bruising at the puncture site, or infection. Direct visualization of the needle tip may aid identification of arteries and veins in the area. This decreases the likelihood of inadvertently puncturing a blood vessel during block placement. The area where the needle is inserted is antiseptically cleaned and a sterile cover is placed on the ultrasound probe to help minimize infection risk.
Nerve damage after a regional block is a rare occurrence. It can be caused by injury to the nerve directly from the needle, or related to secondary complications, such as infection or hematoma formation. To prevent injury, the anesthesiologist will ask you to tell them if you feel sharp or radiating pain while they are positioning the needle and during injection of the local anesthetic.
Ideally patients should be given a leaflet regarding anaesthesia and then counselled regarding the intended benefits and the risks of anaesthesia. In a general practice setting it will be the responsibility of the clinician who administers the local anaesthesia to ensure good, non-coercive consent is obtained.
Aitkenhead AR ; Injuries associated with anaesthesia. A global perspective. Br J Anaesth. StatPearls Publishing BMC Anesthesiol. Cochrane Database Syst Rev. I have surgery on tuesday for the investigqtion of adno minal pains. Despite having three general anesthic surgies last year i am territerrified of going under. Last time i was uncontrollable in the Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions.
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This article is for Medical Professionals. In this article Anaesthesia Important complications of general anaesthesia Some specific complications of general anaesthesia Important complications of regional anaesthesia Some specific complications of regional anaesthesia Important complications of local anaesthesia. Important Complications of Anaesthesia In this article Anaesthesia Important complications of general anaesthesia Some specific complications of general anaesthesia Important complications of regional anaesthesia Some specific complications of regional anaesthesia Important complications of local anaesthesia.
Anaesthesia Anaesthesia is from the Greek and means 'loss of sensation'. There are three main types of anaesthesia. General anaesthesia The patient is sedated, using either intravenous medications or gaseous substances, and occasionally muscles paralysed, requiring control of breathing by mechanical ventilation.
Important complications of general anaesthesia Pain. Damage to teeth. Modern anesthetics and updated delivery methods have improved the speed of onset, general safety, and recovery, but the four stages remain essentially the same:. Stage 1, or induction: This phase occurs between the administration of the drug and the loss of consciousness. The patient moves from analgesia without amnesia to analgesia with amnesia. Stage 2, or excitement stage: The period following a loss of consciousness, characterized by excited and delirious activity.
Breathing and heart rate becomes erratic, and nausea, pupil dilation, and breath-holding might occur. Because of irregular breathing and a risk of vomiting, there is a danger of choking. Modern, fast-acting drugs aim to limit the time spent in stage 2 of anesthesia. Stage 3, or surgical anesthesia: Muscles relax, vomiting stops and breathing is depressed.
Eye movements slow and then cease. The patient is ready to be operated on. Stage 4, or overdose: Too much medication has been administered, leading to brain stem or medullary suppression. This results in respiratory and cardiovascular collapse. The exact mechanisms that conspire to produce the state of general anesthesia are not well known. The general theory is that their action is induced by altering the activity of membrane proteins in the neuronal membrane, possibly by making certain proteins expand.
Of all the drugs used in medicine, general anesthetics are an unusual case. Rather than a single molecule acting at a single site to produce a response, there is a huge variety of compounds, all of which generating quite similar but widespread effects, including analgesia, amnesia, and immobility. General anesthetic drugs range from the simplicity of alcohol CH 3 CH 2 OH to the complexity of sevoflurane 1,1,1,3,3,3-hexafluoro fluoromethoxy propane.
It seems unlikely that just one specific receptor could be activated by such different molecules. General anesthetics are known to act at a number of sites within the central nervous system CNS. The importance of these sites on the induction of anesthesia is not fully understood but they include:. A number of different neurotransmitters and receptors are also known to be involved in general anesthesia:. Although general anesthetics hold many mysteries, they are hugely important in surgery and the field of medicine at large.
Anesthesiologist Christopher Troianos, MD , offers some insights to help separate fact from fiction. He highlights five key points about anesthesia that are sometimes misunderstood or have changed in recent years. He emphasizes that anesthesia is safer today because of advances in both technology and medication. Although most anesthesia wears off fairly quickly, you may still feel groggy or have impaired judgment after surgery.
Troianos says. This is temporary for most patients but for others these symptoms may persist for a few months after surgery. In the past, people who had an epidural or spinal block had a risk of paralysis because of the anesthetic, Dr. So if the alcohol leaked into the bottle, that could cause paralysis.
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