Anesthesia Complications Flashcards
What are some respiratory complications?
Aspiration Laryngospasm and bronchospasm Airway and resp obstruction Hypoventilation Pulmonary embolism Pneumothorax Intercostal muscle spasm Atelectasis Pulmonary edema Pseudocholinesterase deficiency
What can happen with aspiration of acidic gastric juices?
Leads to chemical pneumonitis, Edema, Alveoli collapse, Ventilation-perfusion mismatch, Results in hypoxemia
What can happen with aspiration of solid emesis?
Edema, severe hypoxia, resp obstruction
Exaplain bronchospasm
Contraction of smooth muscle in walls of bronchi and bronchioles causing narrowing of the lumen
Explain laryngospasm
Partial or complete closure of the vocal cords as an involuntary reflex action.
What is the most frequent cause of resp difficulty in immediate post op period?
Obstruction
How is the airway maintained in obstruction?
Using an oral airway or endnotes heal tube.
Where do the majority of thrombi occur that can detach and cause a pulmonary embolism?
Deep veins of legs and pelvis
What is a pulmonary embolism?
Obstruction of a pulmonary artery or one of its branches by an embolus (often a blood clot)
What is a pneumothorax?
Collection of free air in chest outside lung.
Causes lung to collapse
A pneumothorax is rare but can occur when?
During subclavian catheter insertion or needle insertion into thoracic cage
What are he symptoms of a pneumothorax?
Pain and sob
How is a pneumothorax diagnosed and treated?
X-ray,
Chest tube with underwater seal
When does an intercostal muscle spasm occur? How do u fix it?
After lg dose of fentanyl or on emergence fr general anesthetic
May reverse itself or neuromuscular blockers are given.
What is atelectasis?
Partial lung collapse
What causes atelectasis?
Mucous obstructing bronchus, air in alveoli distal to obstruction is reabsorbed
Segment of lung collapses and consolidates. Retained mucous becomes contaminated by inhaled bacteria
Explain pseudocholinesterase deficiency.
Inherited condition where person cannot metabolize succinylcholine because there is no pseudocholinesterase enzyme.
People have prolonged paralysis if resp muscles.
Pt ventilated until breathing function returns
Go to icu
What are mildly hypertensive pts prone to with anesthesia and at what phase are they prone to it?
Prone to myocardial ischemia during induction and emergence
What is venouspasm caused by?
Cold IV fluid infusion
Slow flow
What relieves a venospasm?
Iv procaine
Thrombophlebitis may follow venospasm
What are some symptoms for an airembolism?
Cardiac dysrhythmias
Hypotension
Heart murmur audible with stethoscope or Doppler
Treatment for an air embolism
Preop placement of cvp catheter allows immediate aspiration of air
With no cvp in place for ventricular obstruction place pt in steep head down position with the right side up
What is disseminated intravascular coagulation?
Normal clotting function does not function
Repetitive over active cycle of clot formation
Simultaneous clot breakdown (fibeinolysis) occurs
Leads to consumption of platelets and coagulation factors
Release of fibrin degradation products that act as potent anticoagulants.
Treatment for DIC
Control of primary condition
Blood, plasma
Dextran given IV
heparin and clotting factors given early to prevent hemorrhage
