Top 5 Complications of Anesthesia and How They’re Managed
While anesthesia is remarkably safe, rare but serious complications can arise. Recognizing and managing these complications swiftly and effectively is critical for patient safety. Here, we highlight the top five anesthesia-related risks and outline essential strategies for their management.
MK Waikwa
4/6/20251 min read
1. Malignant Hyperthermia (MH)
Description: A life-threatening hypermetabolic state triggered by exposure to certain anesthetic agents, primarily volatile anesthetics and succinylcholine.
Symptoms: Rapidly rising temperature, muscle rigidity, hypercarbia, metabolic acidosis, and tachycardia.
Management:
Immediate discontinuation of triggering agents.
Administration of intravenous dantrolene sodium.
Active cooling and supportive therapy for metabolic derangements.
2. Anaphylaxis
Description: Severe allergic reaction to anesthetic drugs, latex, or other perioperative substances.
Symptoms: Hypotension, bronchospasm, rash, and swelling.
Management:
Immediate cessation of the offending agent.
Epinephrine administration, intravenous fluids, and antihistamines.
Corticosteroids and airway management, if needed.
3. Aspiration Pneumonitis
Description: Lung injury resulting from aspiration of stomach contents during anesthesia.
Symptoms: Coughing, hypoxia, and respiratory distress.
Management:
Prevention through fasting guidelines and rapid-sequence induction.
Immediate suctioning of airway and supportive respiratory care.
Monitoring and treating possible secondary infection.
4. Postoperative Cognitive Dysfunction (POCD)
Description: Cognitive decline post-anesthesia, particularly prevalent in elderly patients.
Symptoms: Memory loss, attention deficits, confusion, and difficulty concentrating.
Management:
Minimize exposure to certain anesthetic drugs and maintain optimal cerebral perfusion.
Comprehensive preoperative cognitive assessment and postoperative cognitive therapy.
Early mobilization and family involvement in patient care.
5. Awareness Under Anesthesia
Description: Rare instances when patients regain consciousness and have recall during general anesthesia.
Symptoms: Patient reports recollection of intraoperative events post-surgery.
Management:
Employ monitoring systems like Bispectral Index (BIS) to assess anesthetic depth.
Ensure appropriate dosing and functioning anesthetic delivery systems.
Post-event psychological counseling and support.
Conclusion
Understanding, early recognition, and prompt management of these serious anesthesia complications significantly enhance patient outcomes and safety. Vigilant anesthetic practice, rigorous monitoring, and rapid response to adverse events are foundational to excellent anesthetic care.