Complications in Anesthesia

AnesthesiaAnesthesia-related complications still exist and account for significant morbidity. This chapter reviews common complications encountered throughout anesthesia practice, its etiology, and management. Trauma results from a variety of anesthesia procedures, such as airway manipulation, vascular access, positioning, and peripheral nerve blockade. Dental injury is the most common upper airwayUpper airway anesthesia injury, but airway managementAirway management can cause injury to all upper airway structures including the nostrils, tongue, pharynx, larynx, trachea, and esophagus. Esophageal perforation can lead to death. Vascular access is essential for anesthesia practice, but can lead to multiple complications including arterial and venous thrombosis, thrombophlebitis, sheared catheter, intra-arterial injections, air embolism, cardiac/vascular perforation, pulmonary artery rupture, etc. Anesthesiologists should be aware of preventing peripheral neuropathy resulting from excessive pressure applied to the mask, tourniquet use, positioning, and intraneural injection. Corneal abrasions are the most common eye injury during non-ophthalmologic surgeries, while postoperative vision loss is a rare, but devastating complication. Preventing an operating roomOperating room (OR) fireFire standards and guidelines is an important patient safetyPatient safety issue and anesthesiologists should use the lowest oxygen concentration in laser airway procedures to avoid airway burns, which is a disaster for the patient. Mild hypothermia is common during general anesthesiaAnesthesia due to impaired thermoregulation and cold environmental exposure. However, it is important to keep the patient warm during surgery due to the many adverse effects that hypothermia has, including increased metabolic demand, shivering, increased surgical infection, and delayed wound healing. Both laryngospasmsLaryngospasm and bronchospasms are severe respiratory complications and require rapid treatment to avoid mortality. Post-obstruction pulmonary edema occurs most common after a laryngospasm and is treated with supportive measures and positive ventilation in severe cases. AnaphylaxisAnaphylaxis is defined as a serious, generalized or systemic allergic or hypersensitivity reaction that can be life threatening. The most common triggers of anaphylaxis during anesthesiaAnesthesia are neuromuscular-blocking agents (NMBAs), antibiotics, latex, hypnotic agents, opioidsOpioids, and colloidsColloids. Immediate recognition of anaphylaxis is a key to preventing mortality. Epinephrine is the first-line drug to restore circulation in the event of circulatory collapse. PerioperativePerioperative pulmonary aspirationAspiration occurs after the induction of anesthesiaAnesthesia, during a procedure, or in the immediate period after surgery. The American Society of Anesthesiologists (ASA) fasting guideline should be followed to prevent the aspiration of gastric contents.