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complication of anaesthesia and post operative care v2003 .pdf



Original filename: complication of anaesthesia and post operative care v2003.pdf
Title: Complication during Anaesthesia
Author: imart

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Complications Of Anaesthesia
&
Post Operative Care
Prof. Dr. A.K.M. Nur Nobi
Chowdhury
Head
Department of Anaesthesia
IMC & BIRDEM

1

Complication of Anaesthesia

Complication during GA
 Complication during Regional
Anaesthesia
 Complication during LA


2

Complication during GA
The risk increases with:
- Duration of surgery
- Obesity
- Extremes of age
- Emergency anaesthesia & obstetric
anaesthesia

3

Complication: GA
Cardiovascular complications
 Respiratory complications


– Intubation problems

Hypo/ Hypervolaemia
 Aspiration of gastric contents
 Adverse drug reactions
 Hypo/ hyperthermia
 Awareness
 Injury & Equipment problems


4

Cardiovascular complications:
Arrhythmia
 Hypotension
 Hypertension
 Hypo / Hypervolaemia
 Myocardial Ischaemia
 Cardiac arrest
 Embolism


5

Cardiovascular complication:


Arrhythmias:
Bradycardia
Tachycardia
Atrial arrhythmias- SVT, AF or flutter
Ventricular arrhythmias- PVCs, VF/VT
Heart blocks
6

Arrhythmias causes:
Cardiorespiratory:
Hypoxaemia,
Hypotension
Hypo/hypercapnia
Metabolic:
Catecholamines (exo/endogenous)
Hypo/hyperkalaemia
Surgical
Drugs

7

CVS Complications(arrhythmias)
(managements)
Preoperative
correction of fluid,
electrolyte & acidbase imbalance.
 Continuous
intraoperative ECG
monitoring.
 Exclude hypoxia,
hypotension &
inadequate analgesia.


Correction of
precipitating factors.
 Bradycardia –
Atropine,
glycopyrrolate,
I.v isoprenaline or
cardiac pacing.
 Tachycardia – β –
blocker(propanolol or
esmolol)


8

CVS Complications
(Hypotension)
Systolic BP ↓>30%
Causes :
Hypovolaemia
Induction agents (pt. with CV disease)
Volatile agents (halothane, enflurane, isoflurane)
SAB & epidural block.
Cardiac diseases: MI,arrhythmias, pul.Embolism.
Resp. diseases : Pneumothorax.
Hypersensitivity reactions.
9


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