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Complications of General Anaesthesia

  1. During anaesthesia
    1. ​Respiratory depression and hypercarbia.
    2. Salivation, respiratory secretions-less now as nonirritant anaesthetics are mostly used.
    3. Cardiac arrhythmias, asystole.
    4. Fall in BP
    5. Aspiration of gastric contents: acid pneumo­nitis.
    6. Laryngospasm and asphyxia.
    7. Awareness: dreadful perception and recall of events during surgery-by use of light anaes­thesia + analgesics and muscle relaxants.
    8. Delirium, convulsions and other excitatory effects are generally seen with i.v. anesthetics especially if phenothiazine or hyoscine have been given in premedication. These are suppressed by opioids.
    9. Fire and explosion-rare now due to use of non-inflammable agents.
  2. ​After anaesthesia (Post operative)
    1. Nausea and vomiting.
    2. Persisting sedation: impaired psychomotor function.
    3. Pneumonia, atelectasis.
    4. Organ toxicities: liver, kidney damage.
    5. Nerve palsies-due to faulty positioning.
    6. Emergence delirium.
    7. Cognitive defects: prolonged excess cognitive decline has been observed in some patients, especially the elderly, who have undergone general anaesthesia, particularly of long duration.
  3. ​Drug interactions
    1. ​Patients on antihypertensives given general anaesthetics (Halothane)-BP may fall markedly.
    2. Neuroleptics, opioids, clonidine and mono­ amine oxidase inhibitors potentiate anaesthetics.
    3. Halothane sensitizes heart to Adrenaline & nor adrenaline
    4. If a patient on corticosteroids is to be anaesthetized, give 100 mg hydrocortisone (IV) intraoperatively because anaesthesia is a stress-can precipitate adrenal insufficiency and cardiovascular collapse.
    5. Insulin need of a diabetic is increased during GA: switch over to plain insulin even if the patient is onoral hypoglycemics.

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