complications of general anesthesia
TRANSCRIPT
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COMPLICATIONS OF GENERAL
ANESTHESIA PROF. N K AGRAWAL
JNMC,SAWNGIWARDHA
INDIA
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INDUCTION
MUCSLE RELAXATION
INTUBATION
VENTILATION
REVERSAL
STEPS OF ANESTHESIA
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The complication may be divided
Intra operative
Post operative
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Due to - laryngoscopy - endotracheal tube Aspiration - secretions - blood Due to anesthetic drugs- hypoxia -
hypotension/hypertension
- hypercarbia/hypocarbia -
hypothermia/hyperthermia
INTRA OPERATIVE
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Hypoglycemia/hyperglycemia
Less or over fluid infusion
Anemia
Hyper thyrodism/ hypothyroidism
IHD, MI
Air embolism , fat embolism
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TRAUMA TO LIPS
TRAUMA TO TEETH
TRAUMA TO TONGUE
TRAUMA TO TONSILAR PILLAR
TRAUMA TO EPIGLOTIES, VOCAL CORDS
DUE TO LARYNGOSCOPY
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Injury to vocal cords
Injury to trachea
Blockage of tube – secretions - blood clot - foreign body Branchospasm
Due to endo tracheal tube
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Low oxygen pressure Spo2- < 92 %
Pao2-< 60 mm of hg
Hypoxia
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Normal ETCO2- 30 -42 mm hg
> 50 mm Hg
Hyper carbia
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Systolic BP < 80 mm Hg
10 % fall in blood pressure from base line
Hypotension
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Fasting – 80-120 mg/dl
Post meal- 120-180 mg/dl
Normal blood sugar
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Blood sugar < 60 mg/dl
Hypoglycemia
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Blood sugar > 200 mg/dl
Hyperglycemia
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Normal 98.4 f
< 96 f
Hypothermia
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Maintenance- 2ml/kg/hr
Intra operative- 4ml/kg/hr – 8ml/kg/hr
Urine out put < 1ml/kg/hr
Fluid infusion
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Signs of retention of fluid
edema over eyes
Pulmonary edema
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Anemia
IHD
MI
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Inadequate reversal
Laryngospasm
Bronchospasm
Meiosis
Bradycardia
Urine retention
POST OPERATIVE
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Aspiration
Hypoxia
Hypercarbia
Hypo/hyperglycemia
Hypotension
Immediate
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Hoarseness of voice
Soar throat
Cough
Tracheities
Tracheal stenosis
Delayed
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P A C --DELAY SURGERY IF
URI FEVER DM HT IHD MI HYPERTHYROIDISM
HOW TO PREVENT ?
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4- 6 HOURS
N B M
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ANTI-PSILOGOGUS ANTI-EMETIC ANTI-HISTAMINIC ANTA-ACID ANALGESIC AMNESIA ADDITIVE
PRE MEDICATION
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PULSE BP SPO2 ETCO2 TEMPERATURE GLUCOSE ECG
MONITORING
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WAIT TILL PATIENT CAN BREATH ON ROOM AIR MINIMUM FOR 5 MIN
CONCIOUS RESPONDING REGULAR RESPIRATION RRGULAR HR NORMAL BP
POST OPERATIVE
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KEEP IN I C U