anesthesia and its complication

Anesthesia and its Complication

Potential complication related to hazardous drug interactions

1. Antibiotics and curariform muscle relaxant

Ex: Neomycin SO4 streptomycin SO4polymycin A and B SO4

colistin SO4kanamycin SO4.

2. antidepressants

MAO (monoamine oxidase) inhibitors

3. diuretics

thiazides

4. antihypertensives

ReserpineHydralazinemethyldopa

5. anticoagulants

HeparinCoumadin

6. aspirin

7. steroids

cortisone

GA

1. CARDIAC ARREST

GA

2. RESPIRATORY DEPRESSIONa. Excessive mucusb. CNS depressionc. Bronchospasm/

laryngospasm

GA

3. HYPOTENSION AND SHOCK

GA

4. LOSS OF PROTECTIVE RESPONSE TO PAIN

GA

5.VOMITING AND ASPIRATIONS

GA 6.

GA

7. Malignant hyperthermia: possible

treatment with dantrolene

Treatment of Complications

Establish an open airway.Give oxygen.Notify the surgeon.Fast-acting barbiturate is usual

treatment. If toxic reaction is untreated,

unconsciousness, hypotension, apnea, cardiac arrest, and death may result.

RACOMPLICATIONS

RA

1.Anaphylaxis Immunologic sensitization methylparaben

Overdosage Hazardous site:▪ Vascular: Tracheobronchial

mucosa▪ Tissue: head, neck,

paravertebral.

RA

1.HYPOTENSION

Mgt:

PREVENTION: Infuse 500-800 mL of IV

if not prone to CHFINTERVENTION: Oxygen administration Vasoconstrictive drugs Trendelenburg position

10-20 mins after induction

PREVENTION:Avoid extreme trendelenburg position before level of anesthesia sets

INTERVENTION:Artificial airway

Mgt:

2.NAUSEA AND VOMITINGINTERVENTION: Oxygen administration Give ephedrine, anti-

emetics IVF

RA

3.HEADACHE – excessive loss of CSF due to:a.Loss of large

spinal fluidb.Poor hydration

PREVENTION:Use of small needleAdminister IV before and after induction

Keep well hydrated to aid in spinal fluid replacement.

inject client blood to plug the hole (10cc)

Flat on bed for 6 to 8 hours

INTERVENTION:Apply tight abdominal binder

IV administrationAnalgesic

RA

4.Overdosage

Complications/ Discomforts of Regional Anesthesia:

5. RESPIRATORY PARALYSIS – happens when drug reaches upper thoracic and cervical cord in large amount or in heavy doses

6. Neurological Complication- maybe due to:a. unsterile needle, syringes or anesthetic agentb. per-existing disease of CNSc. transient response to anestheticsd. position during surgery

Mgt:

supportive care for transient forms

antibiotic and steroid therapy

rehabilitation for permanent paralysis

RAS/S By systems

The side effects of local anesthetics Local effects- local irritation and skin

breakdown CNS effects if systemic absorption

occurs- headache, restlessness, anxiety, dizziness, tremors and blurred vision.

GI system- nausea, vomiting Cardio- arrhythmias, peripheral

vasodilation, myocardial depression, and rarely, cardiac arrest

ANY QUESTION?