Complications in anesthesia Flashcards
what are complications of induction anesthesia (3)
- airway injuries
- eye injuries
- positional injuries
what airway injuries can occur
Injuries to the mouth structures, throat etc. which are caused by placement of laryngoscope blade, oropharyngeal airway, laryngeal mask airway or ETT.
what eye injuries can occur (2)
- Facemask pressure on eyes.
- Corneal ulceration due to loss of blink reflex due to anesthesia.
how can you prevent corneal ulceration
tapping the eyes closed
what positional injuries can occur
pressure injuries on peripheral nerves and nerve damage due to improper positioning
what nerves are at risk in positional injuries (5)
- Radial nerve(Saturday night palsy)
- ulnar nerve
- brachial plexus nerves injuries,
- lateral popliteal nerve in the lithotomy position(foot drop),
- femoral nerve damage in Lloyd Davis(extended lithotomy position).
how can the positional injuries be prevented
by putting padding in the pressure points
what are complications of regional anesthesia (7)
- Epidural abscess
- Meningitis
- Epidural hematoma
- Nerve injuries
- Post spinal headache
- Hypotension
- High spinal /total spinal
what are early complications of central venous cannulation (4)
- Technical
- Pneumothorax
- Hemothorax - Nerve damage
- Dysrhythmias (guide wire related)
- Air embolism
what are late complications of central venous cannulation (4)
- Infection-sepsis
- Endocarditis
- Thrombosis
- tamponade
what risk factors can result in the complication post-operative nausea and vomiting (PONV) (4)
- anesthetic factors
- patient factors
- surgical factors
- post op factors
what anesthetic factors can cause PONV (3)
1.Prolonged pre-op starvation
2.Hypotension from spinal or epidural
3.Emetic drugs
- opiates
- etomidate
- ketamine
- N2O
- Volatile anaesthetics
what patient factors cause PONV (5)
- Children
- females
- history of motion sickness
- previous PONV
- Obesity
what surgical factors can cause PONV (5)
- Ear or eye surgery
- intraabdominal surgery
- laparoscopy
- gynaecological surgery
- orchidopexy
what post op factors can cause PONV ( 4)
- Pain
- opiates
- forced oral fluids too soon
- hypotension
how can you prevent or reduce the incidence of PONV (3)
- Avoid emetic drugs
- Regional anesthesia
- TIVA ( total intravenous anesthesia) with Propofol
what are pharmacological ways of managing PONV
Anti-emetic drugs:
- Droperidol
- Butyrophenone
- Prochlorperazine
- Ondansetron
- Dexamethasone
- metoclopromide
what are non pharmacological ways of managing PONV
keeping patient well hydrated
what causes the complication awareness (2)
- faulty equipment
- light anesthesia
what can the complication hypothermia cause (5)
- coagulopathy
- poor ventilatory efforts
- dysrhythmias
- slowed drug metabolism
- increased o2 consumption during shivering.
how can you prevent hypothermia (4)
- Forced air warming blanket (bear hugger)
- Warm IV fluids and irrigating fluids
- Warm inhaled gases
- Warm the theatre temperature if necessary
how can endotracheal intubation result in complications (4)
- Failure to intubate
- Dislodge or go too deep resulting in endobronchial intubation
- Kinking
- Obstruction with foreign body or secretions
what are risk factors for aspiration (7)
- Full stomach
- Ileus
- Acute abdomen
- Hiatus hernia
- Pregnancy
- Obesity
- Gastric outlet obstruction
how can aspiration result in complications
Perioperative aspiration of gastric contents can cause a chemical pneumonitis (Mendelson syndrome) and may result into a fatal ARDS.
how can you prevent aspiration (2)
- Starving for 6 hours of solid food and for 2 hours at least of clear fluids prior to elective procedure
- To avoid trauma as it may delay gastric emptying for hours.
what are cardiovascular complications (4)
- Hypotension
- Hypertension
- Dysrhythmias And Cardiac Arrests
- Myocardial Infarction
what are respiratory complications (6)
- aspiration
- Laryngospasm
- Bronchospasms
- Airway obstruction
- Post operative respiratory depression and hypoventilation
- pneumothorax
how can equipment failure result in complications
Anaesthetic Machine , ventilator Tubings , vaporisers,intubation Equipment , wiring, And Monitors can all malfunction.
what pharmacogenetic diseases complications can arise (4)
- Malignant hyperthermia
- Halothane hepatitis
- Porphyria
- Scoline apnea
what complications can arise from drugs
anaphylaxis
