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1
S., V. "Complications of lumbar anesthesia." Kazan medical journal 22, no. 2 (December 24, 2020): 242. http://dx.doi.org/10.17816/kazmj52914.
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According to the conclusion of LN Poznyanov (Vesti. Sovr. Med., 1925, No. 11), the main danger of lumbar anesthesia is from a drop in blood pressure. To avoid this danger, some authors propose to inject caffeine 5 hours before the operation, others advise adding the latter, in an amount of 0.25-0.5, to the anesthetic solution, and still others, 2-3 hours before anesthesia, repeatedly inject Digalen to the patient. fourth - 0.003-0.004 strychnine. Reschke recommends 3 min. before anesthesia, infect intramuscularly 1 K. Art. adrenaline and, in addition, the same amount should be administered intravenously immediately after anesthesia.
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Borkar Patil, Vijaya P., and Jayshree J. Upadhye. "Anesthetic complications in cesarean section." International Journal of Research in Medical Sciences 6, no. 10 (September 25, 2018): 3215. http://dx.doi.org/10.18203/2320-6012.ijrms20183849.
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Background: Obstetric anesthetists need to face with the unique situation of providing anesthesia for caesarean sections, where they have to provide care for both the mother and the unborn baby. This study was performed in 100 women who underwent cesarean section, either elective or emergency to evaluate type of anesthesia, anesthetic complications and neonatal outcome.Methods: A retrospective study was conducted in 100 women with singleton pregnancy undergoing cesarean section in the department of Anesthesiology in collaboration with department of Obstetrics and gynecology at Dr PDMMC and Hospital, Amravati from January 2017 to March 2018. Detailed information regarding medical and obstetric history, intrapartum course, postpartum complications diagnosed before hospital discharge, and infant outcome were collected directly from maternal and infant charts. Other details like age of the patient, parity, type of cesarean section and type of anesthesia was noted. American Society of Anesthesiologists (ASA) scores and type of anesthesia was noted.Results: In our study, spinal anesthesia was given in 62 (62%) patients, epidural anesthesia was given in 20 (20%) patients, combined spinal-epidural anesthesia was given in 10 (10%) patients while general anesthesia was given in 8 (8%) patients. Anesthetic complications were less. About 10 (10%) patients had spinal headache, 4 (4%) patients had failed regional anesthesia, 2 (2%) patients had failed intubation while 2 (2%) patients had high spinal anesthesia. Babies of 96 (96%) patients had Apgar score at 5 minutes of more than 7 and babies of 4 (4%) patients had Apgar score at 5 minutes of less than 7. Only babies of 2 (2%) patients required intubation for resuscitation.Conclusions: This study provides strong evidence that the guidelines recommending regional block over GA for most cesarean section. It is beneficial for neonates as well as for mothers.
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Singh, Sukhdip, Shagufta Y. Chaudry, Amy L. Phelps, and Manuel C. Vallejo. "A 5-Year Audit of Accidental Dural Punctures, Postdural Puncture Headaches, and Failed Regional Anesthetics at a Tertiary-Care Medical Center." Scientific World JOURNAL 9 (2009): 715–22. http://dx.doi.org/10.1100/tsw.2009.94.
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Obstetric anesthesia-related complications occur as a result of labor epidural or spinal placement. The purpose of this continuous quality-improvement audit was to review the occurrence of accidental dural punctures (ADPs), postdural puncture headaches (PDPHs), and failed regional anesthetics at an academic tertiary-care medical center over a 5-year period. Obstetric anesthesia complications contained in three databases consisting of ADPs, PDPHs, and failed regional anesthetics were matched to a perinatal database, with no complications serving as controls. Of the 40,894 consecutive parturients, there were 765 documented complications. Complication rates were 0.73% (95% CI: 0.65–0.82) for ADP, 0.49% (95% CI: 0.43–0.56) for PDPH, and 0.65% (95% CI: 0.57–0.73) for failed regional anesthetic. When compared to the no complication group, factors associated with obstetric anesthesia complications included increased weight and BMI (p< 0.01), epidural block (p< 0.01), and vaginal delivery (p< 0.01).
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Suri, Nikita, Geeta Kalra, Mandeep Kumar, Abhishek Avasthi, Tarun Kalra, and Ramandeep Singh. "A literature review on various complications associated with administration of local anesthesia in dentistry." IP International Journal of Maxillofacial Imaging 8, no. 2 (July 15, 2022): 63–66. http://dx.doi.org/10.18231/j.ijmi.2022.015.
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To perform any surgical procedure, we require administration of safe as well as effective local anesthesia. The prime and the most important step in any clinical oral surgical procedure is the administration of local anesthesia. Almost in most of the clinical steps in dentistry, local anesthesia is used, therefore there are chances of complications that might occur with the administration of the local anesthetic drug. It is advised to take the proper history of the patient, i.e., is there any systemic complication that might get enhanced with the administration of the local anesthetic agent. Ask and verify, whether the patient is allergic to any specific medicine or allergic to the local anesthetic agent, to avoid any sort of complication.
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Maria I. Dalamagka. "Anesthesiology complications in children." International Journal of Science and Research Archive 12, no. 1 (June 30, 2024): 2924–27. http://dx.doi.org/10.30574/ijsra.2024.12.1.1179.
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General anesthesia is defined by the American Society of Anesthesiologists as a “drug induced loss of consciousness during which patients are not arousable, even by painful stimulation”. The perioperative period, immediately before, during, and after surgery, is a particularly critical time for pediatric patients. Even though anesthesia today is much safer than it has ever been, all anesthesia has an element of risk. General anesthesia has been safely given to children for many years. Improvements in inhalational and intravenous agents have increased the safety profile of general anesthesia and complication rates are low. General anesthesia has also allowed children to undergo painful or anxiety inducing procedures. General anesthesia is a complete loss of consciousness with amnesia, analgesia and neuromuscular blockade. It can be divided into three phases: induction, maintenance and emergence. Induction usually occurs with inhalational anesthetic in children until intravenous access occurs. Propofol, etomidate and ketamine are often used for induction. Maintenance of anesthesia occurs with inhalational or intravenous medications. Common inhalational anesthetics include nitrous oxide, sevoflurane or desflurane. Common intravenous medications used for maintenance are propofol and remifentanil. Typical complications in pediatric anesthesia are respiratory problems, medication errors, difficulties with the intravenous puncture and pulmonal aspiration. In the postoperative setting, nausea and vomiting, pain, and emergence delirium can be mentioned as typical complications. Side effects of anesthesia may include nausea, vomiting, drowsiness, muscle soreness and sore throat. Rare but more serious complications include adverse reactions that affect breathing, allergic reactions and irregular heart rhythms. Airway and respiratory events are the most common perioperative complications in pediatric patients. Several studies have reported on the incidence of pediatric airway-related complications. Consistently reported risk factors for serious airway complications include very young age and multiple intubation attempts. Laryngospasm was the most common cause of respiratory related arrests. Other etiologies included airway obstruction, difficult intubation, esophageal intubation, and aspiration.
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Quan, Theodore, Alisa Malyavko, Anna Maria M. Ifarraguerri, Yumin Kim, Lea Mcdaniel, Joseph E. Manzi, Amil R. Agarwal, Frank Chen, Alex Gu, and Sean Tabaie. "Evaluating the Association of Anesthesia Type with Postoperative Complications in Patients Undergoing Ankle Fracture Repair." Foot & Ankle Orthopaedics 7, no. 4 (October 2022): 2473011421S0088. http://dx.doi.org/10.1177/2473011421s00887.
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Category: Ankle Introduction/Purpose: General and neuraxial anesthesia are both successful anesthesia techniques used in many orthopaedic procedures. Neuraxial anesthesia involves local anesthetics placed around the central nervous system (CNS) and spinal anesthesia is a subtype where the anesthetic is injected into intrathecal space. General anesthesia is usually recommended in ambulatory surgeries for its rapid onset of action. However, current literature shows contradicting complication profiles between these two anesthesia types. The purpose of this study was to compare the complications and length of hospital stay between patients who underwent general anesthesia versus neuraxial anesthesia during the repair of ankle fractures. Methods: Patients undergoing open reduction and internal fixation (ORIF) for ankle fracture from 2014 to 2018 were identified in the National Surgical Quality Improvement Program database. Patients were stratified into 2 cohorts: general anesthesia and neuraxial anesthesia. In this analysis, demographics data, comorbidities, and postoperative complications were collected and compared between the two cohorts. Bivariate analyses and multivariable logistical regression were performed. Results: Of 3,585 patients who underwent operative treatment for ankle fracture, 3,315 patients (92.5%) had general anesthesia and 270 (7.5%) had neuraxial anesthesia. Compared to patients who had general anesthesia, those who had neuraxial anesthesia were more likely to be older (58.0 vs 49.6 years old; p<0.001), Caucasian (80.0% vs 71.9%; p=0.001), and have an ASA classification of III (38.1% vs 25.0%; p<0.001). On bivariate analyses, patients who had neuraxial anesthesia were more likely to develop pulmonary complications (p=0.173) or extended length of stay more than 5 days (p=0.342) compared to the general anesthesia group. Following adjustment on multivariate analyses, the neuraxial anesthesia cohort no longer had increased likelihood of pulmonary complications or extended length of stay compared to the general anesthesia group. Conclusion: Prior studies have shown that neuraxial anesthesia methods are as effective as general anesthesia with fewer short- term outcomes. When compared to patients who underwent general anesthesia during ORIF for ankle fracture, neuraxial anesthesia patients experienced no significant increases in postoperative complications or extended length of hospital stay. In terms of the variables we explored in the NSQIP database, healthy ankle fracture patients could also benefit from neuraxial anesthetic methods, and they should be considered for this anesthetic type regardless of their lack of comorbidities that would make them high risk for general anesthesia.
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Afroz, Dr Asma, Dr Rehan Uddin Khan, and Dr Chandra Shekhor Kormokar. "Complication of Anesthesia in Children: A Prospective Observational Study." EAS Journal of Anaesthesiology and Critical Care 5, no. 1 (January 23, 2023): 1–6. http://dx.doi.org/10.36349/easjacc.2023.v05i01.001.
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Background: Any anaesthetic procedure, either regional or general, has some potential for complications. For this reason, careful preoperative assessment and adequate planning of appropriate anesthetic are the cornerstones in safe pediatric anesthetic practice. But in Bangladesh, we have very limited research-based information regarding the complication of anaesthesia in children. Aim of the Study: The aim of this study was to assess the complications of anesthesia in children. Methods: This was a prospective observational study. The study was conducted in Department of Aneaesthesia, ICU & Pain Medicine, Shaheed Suharawardy Medical College and Hospital, Dhaka, Bangladesh during the period from January 2018 to December 2018. In total 62 children, aged between 1 day and 15 years prepared for anesthesia associated surgery were selected as the study subjects. The incidence of intra-operative as well as post- anesthesia recovery room complications was recorded and analyzed. Data were analyzed and by using MS Excel and SPSS version 23.0 program as per necessity. Results: In this study, in analyzing the complications among the participants we observed that, bronchospam and bradycardia and hypotension were the most common intraoperative complications which were found in 11%, 10% and 8% cases respectively. On the other hand, tachycardia, prolonged unconsciousness and hypoventilation were found as the most common postoperative complications among the participants which were found in 19%, 10% and 8% cases respectively. Besides those complications some cases with restlessness, respiratory arrest, pain, shivering, hypertension, hemorrhage and laryngospasm were found in both the periods. Conclusion: Anesthesia-related morbidity and mortality can be minimized with early identification and prompt management of any complication. In this current study we observed that, preterm infants are major prone to develop respiratory complications because of using anesthesia.
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Nouvellon, Emmanuel, Joel L’Hermite, Arnaud Chaumeron, Aba Mahamat, Martine Mainemer, Pierre Charavel, Philippe Mahiou, et al. "Ophthalmic Regional Anesthesia." Anesthesiology 100, no. 2 (February 1, 2004): 370–74. http://dx.doi.org/10.1097/00000542-200402000-00028.
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Background The purpose of this study was to evaluate the efficacy and safety of episcleral single-injection anesthesia in a large number of patients. Methods Over a period of 5 yr, in four institutions, anesthesiologists involved in this prospective study completed a standardized form to evaluate single-injection medial canthus high-volume episcleral anesthesia. The success rate of the block was rated according to an akinesia score. The study parameters included demographic data, surgical procedure, and anesthetic management. All patients were followed up at least until postoperative day 1, and all complications, pain, and discomfort were noted. Statistical analysis was done to assess the risk factors for complications. Results A total of 2,031 patients were included in the study. The most frequent surgical procedures performed were phacoemulsification and posterior chamber artificial lens implantation (91.0%). A total of 66 complications (3.3%) occurred in 60 patients. One patient had a retrobulbar hemorrhage, and 59 had one or two more minor incidents or pain/discomfort with the procedure. The complications consisted of subconjunctival hematoma (1.3%), ocular hypertonia (0.4%), and chemosis (0.30%). Statistical analysis revealed that inexperience in the technique represented a risk factor for complications. Conclusions This is the first survey of a large experience in episcleral single-injection anesthesia, a form of anesthesia that does not preclude sharp-needle complications and does require training. Only one complication occurred among 2,031 patients; however, a larger number of patients is needed to definitively evaluate the safety of episcleral single-injection anesthesia.
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Vishnevskiy, S. A., N. K. Korshunova, and T. Y. Kuznetsov. "Peculiarities of anesthetic support during operations with elevated intraocular pressure." Reflection, no. 1 (June 7, 2022): 31–34. http://dx.doi.org/10.25276/2686-6986-2022-1-31-34.
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Purpose. To develop an algorithm for selection of anesthetic drugs and their dosages for adequate and safe anesthesia during surgical interventions that are performed on patients to reduce elevated intraocular pressure and to minimize the complications that may arise during anesthesia. Methods. The study included 86 cases that underwent surgery to reduce elevated intraocular pressure; 34 surgeries were performed under sub-Tenon anesthesia (39.6 %), 2 under parabulbar (2.3 %) and 50 (58.1 %) under peribulbar regional anesthesia. All the patients underwent dynamic monitoring of homeostasis. Anesthesia support consisted of preoperative preparation, regional anesthesia and drugs administered as a bolus in the operating room. Results and discussion. A list of drugs used during operations performed with increased intraocular pressure has been compiled. The most rational and safe dosages of drugs have been determined. After the introduction of this algorithm, not a single complication was obtained as a result of anesthesia. Conclusions. Implementation of the algorithm for intraoperative anesthesia in patients with elevated intraocular pressure made it possible to achieve: 1) adequate nociceptive and psychoemotional protection; 2) comfort conditions both for patients and for medical personnel; 3) minimizing anesthetic risks and complications. Key words: anesthesiology; ophthalmology; glaucoma; increased intraocular pressure; regional anesthesia.
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ÖZSAYGILI, Cemal, and Nurettin BAYRAM. "Ophthalmic Anesthesia and Related Complications in Vitreoretinal Surgery." Güncel Retina Dergisi (Current Retina Journal) 8, no. 3 (October 22, 2023): 185–91. http://dx.doi.org/10.37783/crj-0403.
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The most critical anesthetic evaluation before vitreoretinal surgery is whether the patient and surgeon need local or general anesthesia. Local anesthesia techniques include topical, retrobulbar, peribulbar, and subtenon blocks. Performing analgesia and akinesia with appropriate anesthesia provides appropriate surgical conditions for the patient and physician, reducing surgical risks. In addition, since complications related to ophthalmic anesthesia may cause permanent visual impairment, managing perioperative complications is of great importance and requires experience.
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De Francisci, Giovanni, Angela Elisa Papasidero, Giorgia Spinazzola, Dario Galante, Marco Caruselli, Dino Pedrotti, Antonio Caso, Massimo Lambo, Matteo Melchionda, and Maria Grazia Faticato. "Update on complications in pediatric anesthesia." Pediatric Reports 5, no. 1 (February 18, 2013): 2. http://dx.doi.org/10.4081/pr.2013.e2.
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Complications in pediatric anesthesia can happen, even in our modern hospitals with the most advanced equipment and skilled anesthesiologists. It is important, albeit in a tranquil and reassuring way, to inform parents of the possibility of complications and, in general, of the anesthetic risks. This is especially imperative when speaking to the parents of children who will be operated on for minor procedures: in our experience, they tend to think that the anesthesia will be a <em>light anesthesia</em> without risks. Often the surgeons tell them that the operation is very simple without stressing the fact that it will be done under general anesthesia which is identical to the one we give for major operations. Different is the scenario for the parents of children who are affected by malignant neoplasms: in these cases they already know that the illness is serious. They have this tremendous burden and we choose not to add another one by discussing anesthetic risks, so we usually go along with the examination of the child without bringing up the possibility of complications, unless there is some specific problem such as a mediastinal mass.
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D’Angelo, Robert, Richard M. Smiley, Edward T. Riley, and Scott Segal. "Serious Complications Related to Obstetric Anesthesia." Anesthesiology 120, no. 6 (June 1, 2014): 1505–12. http://dx.doi.org/10.1097/aln.0000000000000253.
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Abstract Background: Because of the lack of large obstetric anesthesia databases, the incidences of serious complications related to obstetric anesthesia remain unknown. The Society for Obstetric Anesthesia and Perinatology developed the Serious Complication Repository Project to establish the incidence of serious complications related to obstetric anesthesia and to identify risk factors associated with each. Methods: Serious complications were defined by the Society for Obstetric Anesthesia and Perinatology Research Committee which also coordinated the study. Thirty institutions participated in the approximately 5-yr study period. Data were collected as part of institutional quality assurance and sent to the central project coordinator quarterly. Results: Data were captured on more than 257,000 anesthetics, including 5,000 general anesthetics for cesarean delivery. There were 157 total serious complications reported, 85 of which were anesthesia related. High neuraxial block, respiratory arrest in labor and delivery, and unrecognized spinal catheter were the most frequent complications encountered. A serious complication occurs in approximately 1:3,000 (1:2,443 to 1:3,782) obstetric anesthetics. Conclusions: The Serious Complication Repository Project establishes the incidence of serious complications in obstetric anesthesia. Because serious complications related to obstetric anesthesia are rare, there were too few complications in each category to identify risk factors associated with each. However, because many of these complications can lead to catastrophic outcomes, it is recommended that the anesthesia provider remains vigilant and be prepared to rapidly diagnose and treat any complication.
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Patil, Kavitha, Karishma Munoli, Vinod Kumar, and Kartik Venkataraghavan. "Intraoral Local Anesthesia and Ocular Complications." World Journal of Dentistry 4, no. 2 (2013): 108–12. http://dx.doi.org/10.5005/jp-journals-10015-1214.
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ABSTRACT Background Ocular complications due to intraoral local anesthesia are rare but most distressing to the dentist and patient. Ocular complications after local anesthetic injections are rarely reported in the literature and these complications include strabismus, ptosis, diplopia, blindness, ophthalmoplegia, loss of accommodation. The dentist must be vigilant and beware of ocular complications when performing local anesthetic nerve blocks. Aim The aim and objective of this review is to help the dental surgeons to understand about the causes, mechanisms and symptoms of ocular complications to enable them to diagnose, manage and prevent those complications. Materials and methods The revision included a systematic literature search of past 10 years with keywords dental anesthesia, ocular complications, blindness after dental anesthesia, diplopia following dental anesthesia. Papers for review were chosen from the selected articles. When data did not appear sufficient or were inconclusive; recommendations were based upon expert or consensus opinion by experienced researchers and clinicians. Conclusion The various ocular complications, its causes, mechanisms and management are emphasized in this review paper. As per literature review ocular complications are rare to occur but they are most distressing, clinicians should be aware of complications and should be able to diagnose and understand the complications for timely prevention and effective management. How to cite this article Patil K, Munoli K, Kumar V, Venkataraghavan K. Intraoral Local Anesthesia and Ocular Complications. World J Dent 2013;4(2):108-112.
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Von Arx, Thomas, Scott Lozanoff, and Martin Zinkernagel. "Ophthalmologic complications after intraoral local anesthesia." SWISS DENTAL JOURNAL SSO – Science and Clinical Topics 124, no. 7/8 (July 28, 2014): 784–806. http://dx.doi.org/10.61872/sdj-2014-07-08-02.
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Introduction: The first ophthalmologic complication in conjunction with a dental anesthesia was reported in 1936. The objective of the present study was a detailed analysis of case reports about that topic. Material and methods: After conducting a literature search in PubMed this study analyzed 108 ophthalmologic complications following intraoral local anesthesia in 65 case reports with respect to patient-, anesthesia-, and complication- related factors. Results: The mean age of the patients was 33.8 years and females predominated (72.3%). The most commonly reported complication was diplopia (39.8%), mostly resulting from paralysis of the lateral rectus muscle. Other relatively frequent complications included ptosis (16.7%), mydriasis (14.8%) and amaurosis (13%). Ophthalmologic complications were mainly associated with block anesthesia of the inferior alveolar nerve (45.8%) or the posterior superior alveolar nerve (40.3%). Typically, the ophthalmologic complications in conjunction with intraoral local anesthesia had an immediate to short onset, and disappeared as the anesthesia subsided. Discussion and conclusion: The increased number of ophthalmologic complications after intraoral local anesthesia in females may suggest a gender effect. Double vision (diplopia) is the most frequently described complication, which is usually completely reversible like the other reported ophthalmologic complications.
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Rauwelio, Alvin, and I Wayan Widana. "Management and Consideration of Anesthesia Procedures in Eclampsia: A Case Report." Journal of Anesthesiology and Clinical Research 5, no. 2 (May 10, 2024): 600–607. http://dx.doi.org/10.37275/jacr.v5i3.560.
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Introduction: Eclampsia is a serious pregnancy complication with high maternal and fetal mortality rates. The choice of anesthetic technique in eclamptic patients must consider various factors, including the condition of the mother and fetus, the risk of complications, and the experience of the anesthesia team. Case presentation: We report the case of a 21-year-old 39-week-old primigravida (G1P0A0) with severe eclampsia who experienced two tonic-clonic seizures. The patient was intubated in the emergency room and underwent an emergency caesarean section under general anesthesia. The patient was treated in the ICU for one day and extubated on the second day. Conclusion: The choice of anesthetic technique in eclamptic patients must be done individually by considering various factors. The anesthesia team must be experienced in treating eclamptic patients and have the readiness to deal with complications that may occur.
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Narr, Bradly J. "Complications in Anesthesia." Mayo Clinic Proceedings 74, no. 9 (September 1999): 948–49. http://dx.doi.org/10.4065/74.9.948-a.
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West, Larry H. "Complications after anesthesia." Journal of the American Dental Association 113, no. 2 (August 1986): 128. http://dx.doi.org/10.14219/jada.archive.1986.0151.
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Aranda, Margaret. "Complications in Anesthesia." Regional Anesthesia and Pain Medicine 25, no. 3 (May 2000): 333–34. http://dx.doi.org/10.1097/00115550-200005000-00036.
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Weber, Stanley. "Anesthesia-related complications." Anesthesiology Clinics of North America 20, no. 3 (September 2002): xii—xiii. http://dx.doi.org/10.1016/s0889-8537(02)00016-0.
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Wallace, George F. "Complications of Anesthesia." Clinics in Podiatric Medicine and Surgery 8, no. 2 (April 1991): 425–33. http://dx.doi.org/10.1016/s0891-8422(23)00448-2.
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Auroy, Yves, Dan Benhamou, Laurent Bargues, Claude Ecoffey, Bruno Falissard, Frédéric Mercier, Hervé Bouaziz, and Kamran Samii. "Major Complications of Regional Anesthesia in France." Anesthesiology 97, no. 5 (November 1, 2002): 1274–80. http://dx.doi.org/10.1097/00000542-200211000-00034.
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Background Several previous surveys have estimated the rate of major complications that occur after regional anesthesia. However, because of the increase in the use of regional anesthesia in recent years and because of the introduction of new techniques, reappraisal of the incidence and the characteristics of major complications is useful. Methods All French anesthesiologists were invited to participate in this 10-month prospective survey based on (1) voluntary reporting of major complications related to regional anesthesia occurring during the study period using a telephone hotline service available 24 h a day and managed by three experts, and (2) voluntary reporting of the number and type of regional anesthesia procedures performed using pocket booklets. The service was free of charge for participants. Results The participants (n = 487) reported 56 major complications in 158,083 regional anesthesia procedures performed (3.5/10,000). Four deaths were reported. Cardiac arrest occurred after spinal anesthesia (n = 10; 2.7/10,000) and posterior lumbar plexus block (n = 1; 80/10,000). Systemic local anesthetic toxicity consisted of seizures only, without cardiac toxicity. Lidocaine spinal anesthesia was associated with more neurologic complications than bupivacaine spinal anesthesia (14.4/10,000 vs. 2.2/10,000). Most neurologic complications were transient. Among 12 that occurred after peripheral nerve blocks, 9 occurred in patients in whom a nerve stimulator had been used. Conclusion This prospective survey based on a free hotline permanent telephone service allowed us to estimate the incidence of major complications related to regional anesthesia and to provide a detailed analysis of these complications.
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Mahan, KT, and J. Wang. "Spinal morphine anesthesia and urinary retention." Journal of the American Podiatric Medical Association 83, no. 11 (November 1, 1993): 607–14. http://dx.doi.org/10.7547/87507315-83-11-607.
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Spinal anesthetic is a common form of surgical anesthetic used in foot and ankle surgery. Spinal morphine anesthetic is less common, but has the advantage of providing postoperative analgesia for 12 to 24 hr. A number of complications can occur with spinal anesthesia, including urinary retention that may be a source of severe and often prolonged discomfort and pain for the patient. Management of this problem may require repeated bladder catheterization, which may lead to urinary tract infections or impairment of urethrovesicular function. This study reviews the incidence of urinary retention in 80 patients (40 after general anesthesia and 40 after spinal anesthesia) who underwent foot and ankle surgery at Saint Joseph's Hospital, Philadelphia, PA. Twenty-five percent of the patients who had spinal anesthesia experienced urinary retention, while only 7 1/2% of the group who had general anesthesia had this complication. Predisposing factors, treatment regimen, and recommendations for the prevention and management of urinary retention are presented.
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Hinkelbein, Jochen, Armin Kalenka, and Markus Alb. "Anesthesia for patients with pantothenate-kinase-associated neurodegeneration (Hallervorden-Spatz disease) – a literature review." Acta Neuropsychiatrica 18, no. 3-4 (June 2006): 168–72. http://dx.doi.org/10.1111/j.1601-5215.2006.00144.x.
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Background:Hallervorden-Spatz disease (HSD) is a rare, progressive neurodegenerative disorder; the new and preferred name for HSD is ‘pantothenate-kinase-associated neurodegeneration’ (PKAN). Other suggested names are ‘neurodegeneration with brain iron accumulation type 1’ or ‘infantile neuroaxonal dystrophy’. Patients with PKAN have many complications, which lead to numerous anesthetic management challenges. Reports concerning the anesthetic management of patients with PKAN are very limited.Objective:To determine the anesthetic management and techniques as well as relevant complications for patients with PKAN.Methods:In this study, we review previously published literature regarding the anesthesia-relevant clinical symptoms, the anesthetic management and techniques, and possible complications for this disorder.Results:Only four studies describing the anesthetic management and anesthetic techniques in patients with PKAN were found. Anesthesia-relevant symptoms influence the preanesthetic management (eg difficulties in articulation, dementia), the induction of anesthesia (eg oromandibular rigidity, seizures, dysphagia, aspiration) and the postoperative care (eg respiratory disability).Conclusion:Reports concerning the anesthetic management of patients with PKAN are very limited, possibly as a result of the rareness of the disorder. Like many other patients with neurodegenerative diseases, patients with PKAN have many anesthesia-relevant symptoms, leading to numerous anesthetic management challenges. In general, the anesthetic complications associated with PKAN are usually no different from those associated with other neurodegenerative diseases, and the management of these are usually concordant.
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Triyasunant, Namtip, Patchareya Nivatpumin, Nutthakarn Luangpirom, and Thanyarat Wongwananurak. "Factors influencing decision-making for the anesthetic technique in molar pregnancy patients for suction curettage: A retrospective study." Indian Journal of Clinical Anaesthesia 11, no. 1 (March 15, 2024): 25–31. http://dx.doi.org/10.18231/j.ijca.2024.006.
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Anesthetic techniques for suction curettage in molar pregnancy patients described in the literature can be classed into general anesthesia and regional anesthesia techniques. The aim of the present study was to report the factors influencing the decision-making for the choice of anesthetic technique in molar pregnancy patients who underwent suction curettage at Siriraj Hospital. The reported intraoperative and postoperative complications were also analyzed.A retrospective chart review was conducted among pregnant women diagnosed with molar pregnancy who had underwent suction curettage under anesthesia at Siriraj Hospital between January 2007 to September 2021. Overall, 244 patients were diagnosed with molar pregnancy, with 110 of these included for analysis in this study after consideration of the inclusion and exclusion criteria. Quantitative data of the included patients were analyzed by either unpaired t-test or Mann–Whitney U test, while qualitative data were analyzed by the chi-square test. Logistic regression was used to establish the factors influencing the decision-making for the anesthetic technique.General anesthesia was the most preferred anesthetic technique (77.4%) in the molar pregnancy patients who had underwent suction curettage, followed by regional anesthesia (11.3%) and intravenous sedation (11.3%). General anesthesia was likely to be used in patients with an enlarged uterine size ≥ 16 weeks with an adjusted odds ratio of 11.64 (95% CI 1.08–125.72, p < 0.05). Patients with a larger uterine size were associated with higher beta-hCG levels, resulting in more severe medical complications, such as hyperthyroidism and hyperemesis gravidarum (p < 0.05). Intraoperative complications, such as uterine atony (17.7%), massive hemorrhage (7.3%), and pulmonary edema (4.2%), were confined within patients receiving general anesthesia, but there was no statistical significance. None of the patients had anesthesia-related complications. The reported postoperative serious complications, such as pulmonary edema (4.2%), which required postoperative intubation and transferal to the intensive care unit, were all in the general anesthesia group. Patients with higher co-morbidities were advised by anesthesiologists to receive general anesthesia. However, an enlarged uterine size ≥ 16 weeks was the only factor that had an influence on the decisions of the anesthesiologists to provide general anesthesia.
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Michielsen, A. J. H. C., K. Proost, B. Pardon, L. De Cremer, and S. Schauvliege. "General anesthesia for surgical treatment of urethral obstruction in nine goats." Vlaams Diergeneeskundig Tijdschrift 87, no. 6 (December 28, 2018): 314–25. http://dx.doi.org/10.21825/vdt.v87i6.16049.
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Nine pygmy goats underwent surgical treatment for obstructive urolithiasis in a period of six months. In two cases, (second) revision surgery was necessary resulting in a total of twelve procedures under general anesthesia. Different anesthetic protocols were applied: analgesia was provided by an opioid (12/12) combined with either benzodiazepine (10/12) or an alpha-2 agonist (2/12). Anesthesia was induced with propofol (10/12) or ketamine (2/12) and maintained with isoflurane (8/12) or sevoflurane (4/12) in oxygen in a semi-closed circle system with continuous monitoring during anesthesia. Minor complications were mild bradycardia (4/12), hypotension (3/12), metabolic acidosis (1/12) and hypothermia (12/12). In four cases, epidural anesthesia was performed; in one of those four cases, severe complications developed (paralysis, 1/4). The goat was euthanized later. Although urethral obstruction increases the risk of general anesthesia, the selection of an appropriate anesthetic protocol, adequate preoperative examination/ preparation and detailed monitoring throughout anesthesia reduced the incidence of severe complications in this case series.
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Emeka, Chukwubuike Kevin. "Anesthesia-Related Mortality in Children: A Surgeon’s Perspective." Budapest International Research in Exact Sciences (BirEx) Journal 3, no. 3 (July 3, 2021): 152–57. http://dx.doi.org/10.33258/birex.v3i3.2079.
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Background: Anesthesia-related mortality refers to death resulting from the complications of anesthesia or death due to at least one anesthesia-related complication happening as a cause among the multiple causes of death. The aim of this study was to evaluate the incidence and causes of anesthesia-related mortality in pediatric patients, as experienced by a surgeon. Materials and Methods: This was a retrospective study of children aged 15 years and younger who died at the pediatric surgery unit of Enugu State University Teaching Hospital (ESUTH) Enugu, Nigeria following administration of anesthesia between January 2010 and December 2019. Results: A total of 31,210 pediatric anesthesias/surgeries were performed during the study period; out of which 78 mortalities occurred due to anesthesia. There was male predominance and the median age of the patients was 4 years with a range of 1 week to 12 years. Mortality occurred more in neonates and during emergency surgeries. Airway complications and intussusception were the most common etiology of mortality and pathology in the children respectively. About two-thirds of the deaths occurred in the operating room before commencement of the surgery. Conclusion: Anesthesia-related deaths in children in middle income country like Nigeria are higher than what is obtainable in developed countries. The risk factors for anesthesia-related mortality include male gender, neonates and emergency surgeries. Airway problem is a common cause of mortality.
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Hendra, Hendra hermawan. "FAKTOR RISIKO YANG MEMPENGARUHI TERJADINYA KOMPLIKASI KARDIOVASKULAR PASCA PEMBIUSAN/SEDASI PROSEDURAL PADA PASIEN PEDIATRI." Jurnal Komplikasi Anestesi 11, no. 2 (March 1, 2024): 27–36. http://dx.doi.org/10.22146/jka.v11i2.12446.
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Background: The morphology and physiology of neonates and children differ from those of adults. The most common complications encountered involve respiratory issues followed by cardiovascular problems. The predominant cardiovascular complications in the field of pediatric anesthesia are hemodynamic instability followed by cardiac arrest. Perioperative cardiovascular complications are closely related to a history of prematurity under the age of 1 year, ASA physical status ≥3, concomitant cardiovascular or metabolic diseases, emergency surgeries, and surgical procedures. To date, few risk factors related to the cardiovascular system have been identified in pediatric anesthesia.
Objective: To identify risk factors influencing the occurrence of post-anesthesia/sedation cardiovascular complications in pediatric patients at Dr. Sardjito Hospital, Yogyakarta.
Method: The research design employed in this study was a prospective cohort observation of pediatric patients undergoing anesthesia or procedural sedation at Dr. Sardjito Hospital. Research subject data included demographic characteristics, ASA status, history of concomitant diseases, type of surgery, urgency level, and post-anesthesia complication occurrences. Data normality was tested using the Kolmogorov-Smirnov test, bivariate analysis was conducted using the Fisher test, variables with p-value <0.25 underwent multivariate analysis using logistic regression for categorical data. The results were processed using SPSS version 23.00.
Results: A total of 181 subjects were predominantly male patients aged >5 years. Factors influencing post-anesthetic cardiovascular complications included ASA physical status ≥3 (p=0.033) OR 8.96 (95% CI 2.07 – 38.89), emergency procedures (p=0.043) OR 12.63 (95% CI 1.08 – 147.15), age >5 years (p=0.033) OR 5.67 (95% CI 1.15 – 28.1), female gender (p=0.001) OR 7.85 (95% CI 2.23 – 27.71), and type of surgical procedure (p=0.017) OR 16.64 (95% CI 1.63 – 169.05).
Conclusion: Age >5 years, female gender, ASA physical status ≥3, emergency procedures, and surgical procedures are risk factors associated with the occurrence of post-anesthetic/sedation cardiovascular complications in pediatric patients.
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Gittelman, Paul D., Joseph B. Jacobs, and Jane Skorina. "Comparison of Functional Endoscopic Sinus Surgery under Local and General Anesthesia." Annals of Otology, Rhinology & Laryngology 102, no. 4 (April 1993): 289–93. http://dx.doi.org/10.1177/000348949310200408.
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We present a retrospective comparison of intravenous sedation and general anesthesia techniques employed at New York University—Bellevue Medical Center for functional endoscopic sinus surgery. Some authors have stressed the use of local anesthesia with intravenous sedation in order to avoid complications and reduce blood loss. We have reviewed 232 patients who underwent 401 consecutive ethmoidectomies and maxillary antrostomies. Local anesthesia, employed in 64% of patients, carried an estimated blood loss of 23 mL per side. General anesthesia was associated with an average blood loss of 58 mL per side. The rate of operative complications for local anesthesia was 8.7% per patient, with a 1.6% rate of major complications per side. General anesthesia carried an overall complication rate of 2.4% per patient, with no major complications. General anesthesia is a relatively safe and viable option for endoscopic sinus surgery that in selected cases may be preferable to local anesthesia.
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Tanner, R. Brad, and John A. E. Hubbell. "A Retrospective Study of the Incidence and Management of Complications Associated With Regional Nerve Blocks in Equine Dental Patients." Journal of Veterinary Dentistry 36, no. 1 (March 2019): 40–45. http://dx.doi.org/10.1177/0898756419848165.
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Regional anesthesia of the equine head is commonly performed to allow oral extraction of diseased teeth in the standing horse. The use of 4 blocks (infraorbital nerve, maxillary nerve, mental nerve, and mandibular nerve) is well documented for desensitization of dental quadrants for oral surgery for exodontia, but descriptions of associated complications are limited. A total of 270 regional nerve blocks were performed on 162 equine patients in a second opinion referral hospital setting. Criteria for inclusion in the study included a 24-hour stay in hospital, that the blocks be performed by one clinician and at minimum, a 2-week follow-up examination be performed. A total of 8 complications were identified in 7 patients representing a 2.96% incidence of complication. Complications included supraorbital hematoma (3), local hematoma (2), lingual self-trauma (2), and nerve block failure to desensitize (1). Treatment and management of complications are discussed. Complications associated with regional anesthesia may be reduced by reducing anesthetic volumes, precise needle placement, familiarity with the facial anatomy relevant to nerve blocks, adequate restraint, aseptic technique, postprocedural muzzling, and the use of a newly opened bottle of local anesthetic.
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Song, Liangsong, Shulian Tan, Qingmin Chen, and He Li. "Effect of Fentanyl as an Adjuvant to Brachial Plexus Block for Upper Extremity Surgeries: A Systematic Review and Meta-Analysis of RCTs." Pain Research and Management 2022 (March 19, 2022): 1–13. http://dx.doi.org/10.1155/2022/8704569.
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Objective. To assess if the addition of fentanyl to brachial plexus block has an impact on anesthetic outcomes and complication rates in patients undergoing upper extremity surgeries. Methods. We explore the PubMed, Embase, ScienceDirect, CENTRAL, and Google Scholar databases for all randomized controlled trials (RCTs) comparing adjuvant fentanyl with placebo/no drug for patients undergoing upper extremity surgery under brachial plexus block. Outcomes assessed were onset, duration of sensory and motor anesthesia, complications, and postoperative analgesia scores. Meta-analysis was conducted utilizing a random-effects model. The risk of bias was assessed using the Cochrane Collaboration’s risk of bias assessment tool 2. Certainty of evidence was assessed using GRADE. Subgroup analysis was conducted depending upon the approach of brachial plexus block and type of local anesthetic. Results. Twelve RCTs with 660 patients were included. Addition of fentanyl had no effect on onset of sensory anesthesia (11 studies; MD: 0.48; 95% CI: −1.81, 0.85; I2 = 96%; p = 0.48 ) but significantly shortened onset of motor anesthesia (8 studies; MD: −2.36; 95% CI: −3.99, −0.74; I2 = 96%; p = 0.48 ). Duration of sensory anesthesia (9 studies; MD: 82.81; 95% CI: 41.81, 123.81; I2 = 99%; p < 0.0001 ) and motor anesthesia (7 studies; MD: 93.41; 95% CI: 42.35, 144.46; I2 = 99%; p = 0.0003 ) was significantly increased with addition of fentanyl. The certainty of evidence-based on GRADE was deemed to be moderate for both onset and duration of anesthesia. The incidence of overall complications (nausea/vomiting and pruritis) was significantly higher in the fentanyl group (7 studies; OR: 2.14; 95% CI: 1.04, 4.40; I2 = 8%; p = 0.04 ) but with low certainty of evidence. Conclusions. Adjuvant fentanyl with brachial plexus block improves the onset of motor anesthesia but not sensory anesthesia. The duration of both sensory and motor anesthesia is significantly prolonged with fentanyl by around 83–93 minutes. However, clinicians should be aware that complications such as nausea/vomiting and pruritis are increased twofold with the addition of the drug. Current evidence is limited risk of bias in the RCTs and high heterogeneity in the meta-analyses.
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Afroz, Dr Asma, Dr Rehan Uddin Khan, and Dr Chandra Shekhor Kormokar. "General Anesthesia Complications in Different Surgeries: A Single Center Study in Bangladesh." Saudi Journal of Medicine 8, no. 1 (January 23, 2023): 18–23. http://dx.doi.org/10.36348/sjm.2023.v08i01.003.
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Background: General anesthesia is very common anesthetic procedure which is used in several surgical approaches. Without general anesthesia many of these surgeries are lifesaving or life-changing and would not be possible. But all medical procedures are associated with some complications, even when they are performed by experts. The severity and rate of these complications depend on patient’s state of health, age or general lifestyle. Though the general anesthesia using is considered safe, but it comes with certain complications. Aim of the Study: The aim of this study was to assess the complications of general anesthesia in different surgeries. Methods: This was a prospective observational study. The study was conducted in the Department of Aneaesthesia, ICU & Pain Medicine, Shaheed Suharawardy Medical College and Hospital, Dhaka, Bangladesh during the period from January 2019 to December 2019. In total 57 participants in treatment under various department of the mentioned hospital and was prepared for surgery were included as the study subjects. All the demographic as well as clinical data were recorded. As per necessity all data were processed, analyzed and disseminated by using MS Excel and SPSS version 23.0 program. Results: As the complications of general anesthesia among our participants, we found somnolence, ‘dry mouth/increased thirst’ and pain in operated place were found in more than 50% cases separately which were found in 67%, 79% and 82% cases respectively. On the other hand, in 25>50% cases disorder of consciousness (25%), ‘weakness and pain of muscles (28%)’, ‘nausea and vomiting (30%)’, headache (33%) and ‘sore throat/hoarseness (37%)’ were found separately which was noticeable. Besides these, breathing problems, urination problems and feeling cold/chills were observed in some cases. Conclusion: Usually, general anesthesia is a safe way for ensuring patient’s safety and comfort during surgery, but till now it is associated with some complications which have to be recognized and deal with. Contentious development in the procedure of using general anesthesia is necessary to reduce unwanted complication.
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Mangla, Chanchal, Kimmy Bais, and Joel Yarmush. "Myotonic Dystrophy and Anesthetic Challenges: A Case Report and Review." Case Reports in Anesthesiology 2019 (March 20, 2019): 1–9. http://dx.doi.org/10.1155/2019/4282305.
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Providing anesthesia to patients with myotonic dystrophy (DM) can be very challenging due to the multisystemic effects of the disease and extreme sensitivity of these patients to sedatives, opioids, and anesthetic agents. Other factors such as hypothermia, shivering, or mechanical or electric stimulation during surgery can precipitate myotonia which is difficult to abolish and can lead to further complications. Generally, local or regional anesthesia is preferred to avoid the complications associated with general anesthesia in this group. However there are several case reports of successful use of general anesthesia (with or without volatile agents and with or without opioids). These general anesthetic cases led to postoperative admission to the regular floor or ICU. We present a case of a woman with a history of DM who underwent robotic assisted laparoscopic hysterectomy under general anesthesia and was discharged home on the same day.
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Gu, Li, Hongqiang An, Xifeng Zhang, and Wenxu Jiang. "Clinical Application of Ultrasound Microscopy-Guided Pediatric Brachial Plexus Nerve Block Anesthesia." Contrast Media & Molecular Imaging 2022 (June 23, 2022): 1–6. http://dx.doi.org/10.1155/2022/3383898.
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In order to investigate the anesthetic effect and safety of the ultrasound-guided brachial plexus block in pediatric upper limb surgery, this study retrospectively analyzed the anesthetic effect of the ultrasound-guided brachial plexus block in pediatric upper limb surgery. From January 2016 to December 2017, 82 children undergoing upper limb surgery in hospital A were selected and randomly divided into two groups by the coin method, with 41 children in each group. Ultrasound-guided brachial plexus block anesthesia and conventional anatomic localization brachial plexus block anesthesia were performed. The anesthetic drug dosage of sensory block at anesthesia completion time and motor block at onset time was compared between the two groups; the one-time puncture success rate and incidence of anesthesia complications were compared between the two groups (local anesthesia poisoning, nerve injury, pneumothorax, hematoma, and phrenic nerve palsy). The results showed that the anesthesia completion time in the study group was slightly longer than that in the control group. The sensory and motor block occurred earlier in the study group than in the control group. Low doses of narcotic drugs are used. The one-time puncture success rate of the study group was higher than that of the control group. The incidence of anesthesia complications was lower than that of the control group. The one-time puncture success rate was 92.8% in the study group and 75.7% in the control group. Ultrasound-guided brachial plexus block anesthesia has a significant effect in pediatric upper limb surgery, which can improve the anesthetic effect and reduce the incidence of complications, and is worthy of clinical promotion.
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Kim, Ha-Jung, Hee-Sun Park, Yon-Ji Go, Won Uk Koh, Hyungtae Kim, Jun-Gol Song, and Young-Jin Ro. "Effect of Anesthetic Technique on the Occurrence of Acute Kidney Injury after Total Knee Arthroplasty." Journal of Clinical Medicine 8, no. 6 (May 31, 2019): 778. http://dx.doi.org/10.3390/jcm8060778.
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Recent studies have reported the advantages of spinal anesthesia over general anesthesia in orthopedic patients. However, little is known about the relationship between acute kidney injury (AKI) after total knee arthroplasty (TKA) and anesthetic technique. This study aimed to identify the influence of anesthetic technique on AKI in TKA patients. We also evaluated whether the choice of anesthetic technique affected other clinical outcomes. We retrospectively reviewed medical records of patients who underwent TKA between January 2008 and August 2016. Perioperative data were obtained and analyzed. To reduce the influence of potential confounding factors, propensity score (PS) analysis was performed. A total of 2809 patients and 2987 cases of TKA were included in this study. A crude analysis of the total set demonstrated a significantly lower risk of AKI in the spinal anesthesia group. After PS matching, the spinal anesthesia group showed a tendency for reduced AKI, without statistical significance. Furthermore, the spinal anesthesia group showed a lower risk of pulmonary and vascular complications, and shortened hospital stay after PS matching. In TKA patients, spinal anesthesia had a tendency to reduce AKI. Moreover, spinal anesthesia not only reduced vascular and pulmonary complications, but also shortened hospital stay.
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Ida Bagus Reza Nanda Iswara, Wayan Widana. "Breast Lumpectomy Surgery by Pectoral Nerve Block (Pecs Block) Without General Anesthesia – A Case Report." MEDICINUS 34, no. 1 (April 1, 2021): 33–36. http://dx.doi.org/10.56951/medicinus.v34i1.58.
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Breast conserving surgery is usually performed under general anesthesia, or more recently combined with regional anesthesia techniques. Thoracic spinal block, thoracic epidural block, and thoracic paravertebral block are options of regional anesthesia that have been used in breast surgery, but anesthesiologists avoid them due to concern in potency of complications and side effects. After introduced by Blanco in 2011, pectoral nerves (Pecs) block appears as alternative procedure with fewer complications and lower incident of postoperative pain.
In this case report we describe a 32-year-old female patient admitted for elective lumpectomy of the left upper quadrant of the breast. Ultrasound guided Pecs II block was chosen as the anesthetic technique for this patient.
The authors reported succesful management of anesthesia and pain without complications in breast surgery. Pecs II block as single anesthetic technique can be considered safe, advantageous, and effective in breast surgery with good hemodinamic stability and few side effects.
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Pavlova, Kseniya A. "Caudal anesthesia in pediatric practice." Tambov Medical Journal, no. 2 (2023): 44–50. http://dx.doi.org/10.20310/2782-5019-2023-5-2-44-50.
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Caudal anesthesia has been used for more than a hundred years. Caudal epidural blockade is the most commonly used regional technique in children and is considered the safest access to the epidural space. This method of anesthesia is used in combination with general anesthesia. With the correct implementation of this anesthetic manual, the risk of complications is small. The technique is used for peri- and postoperative analgesia in children of different ages. The main advantage of the method is high-quality anesthesia during caudal blockade, it is provided in 95–98 % of cases. The level of anesthesia depends on the amount of anesthetic administered; in some cases it may reach the level of the chest. The same advantage is the rapid onset of adequate analgesia and its long-term effect. For successful regional anesthesia in a pediatric patient, it is necessary for the anesthesiologist to know the anatomical and physiological structures of the body, the pharmacology of local anesthetics and the availability of the necessary medical equipment. The research presents a method of using caudal anesthesia as a component of anesthetic support for surgical interventions performed in children. We present the advantages and disadvantages of such anesthesia, indications and contraindications to its use, analyze possible complications, the implementation method.
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BÜYÜKERKMEN, Elif, Ahmet YÜKSEK, Elif DOĞAN BAKI, and Sezgin YILMAZ. "Comparison of the effects of general anesthesia and deep sedation on anesthesia complications and mortality in endoscopic retrograde cholangiopancreatography procedures." Turkish Journal of Geriatrics 26, no. 1 (March 2023): 48–59. http://dx.doi.org/10.29400/tjgeri.2023.330.
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Introduction: Endoscopic retrograde cholangiopancreatography is extremely painful and uncomfortable when performed without anesthesia. However, the type of anesthesia to be applied remains a matter of debate. In this study, general anesthesia and sedation procedures were compared in endoscopic retrograde cholangiopancreatography performed by the same anesthesia and surgical team over a 5-year period. Materials and Method: Patients aged over 65 years were divided into two groups, general anesthesia and sedation, and their data were analyzed retrospectively. Anesthesia complications, surgical complications, duration of the procedure, need for intensive care, and length of hospital stay and intensive care needs were compared between groups in 2812 patients. Results: Data from 1885 patients were analyzed. The procedure time and hospital stay were shorter, and anesthesia-related complication rate was lower in the general anesthesia group. Although not statistically significant, mortality was higher, and the need for intensive care was similar to the sedation group. The complication rate significantly increased in patients aged over 75 years Conclusion: Endoscopic retrograde cholangiopancreatography can be performed under deep sedation or general anesthesia. The experience of the anesthetist is an important factor for this choice. The use of sedation in geriatric patients is associated with more complications that require airway interventions. In addition, anesthesia complications due to prolonged procedures were more common in the sedation group. Conclusion: In our study, it was observed that general anesthesia was safer for endoscopic retrograde cholangiopancreatography procedures performed in geriatric patients by an experienced anesthesia and surgical team. Keywords: Geriatrics; Cholangiopancreatography; Anesthesia, General; Deep Sedation.
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Pepe, Franco, Mariagrazia Stracquadanio, Francesco De Luca, Agata Privitera, Elisabetta Sanalitro, and Puccio Scarpinati. "Epidural Anesthesia for Cesarean Section in a Pregnant Woman with Marfan Syndrome and Dural Ectasia." Case Reports in Obstetrics and Gynecology 2017 (2017): 1–5. http://dx.doi.org/10.1155/2017/2126310.
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Marfan syndrome (MFS) is a genetic disorder of connective tissue, characterized by variable clinical features and multisystem complications. The anesthetic management during delivery is debated. Regional anesthesia has been used with success during cesarean delivery, but in some MFS patients there is a probability of erratic and inadequate spread of intrathecal local anesthetics as a result of dural ectasia. In these cases, epidural anesthesia may be a particularly useful technique during cesarean delivery because it allows an adequate spread and action of local anesthetic with a controlled onset of anesthesia, analgesia, and sympathetic block and a low risk of perioperative complications. We report the perioperative management of a patient with MFS and dural ectasia who successfully underwent cesarean section using epidural technique anesthesia. The previous pregnancy of this woman ended with cesarean section with a failed spinal anesthesia that was converted to general anesthesia due to unknown dural ectasia at that time.
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Puri, Kriti, Raksha Kundal, Preeti Goyal Varshney, Vidhi Chandra, Maitree Pandey, and Sunil Kumar. "A retrospective analysis of anesthetic techniques and their related perioperative complications in children undergoing cochlear implant surgeries – our preliminary experience at a tertiary care referral centre." Indian Journal of Clinical Anaesthesia 11, no. 1 (March 15, 2024): 8–13. http://dx.doi.org/10.18231/j.ijca.2024.003.
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: Cochlear implants serve as a favorable option for treatment of hearing loss in children. However, there is limited data regarding the type of anesthetic techniques used and its associated complications in such patients. Hence, the primary objective of this study was evaluation of postoperative nausea vomiting (PONV) with three different general anesthesia techniques in pediatric cochlear implant surgeries. The secondary objectives included assessment of intraoperative and postoperative complications: A retrospective analysis of all children less than 13 years, who underwent cochlear implant surgery at our hospital between December 2019 to February 2022 was performed. Appropriate data were noted. Nine patients each were classified into three groups (Group A, B and C) on the basis of anesthetic techniques used in our institution. Group A received inhalational agent for induction and maintenance, with no Non-Depolarizing Muscle Relaxant (NDMR), Group B patients received Total Intravenous Anesthesia with NDMR and Group C received intravenous induction and inhalational agent for maintenance with NDMR. Twenty-seven patients were included. There were no major intraoperative complications. PONV was noticed in two patients of Group A and one patient of Group C. One patient belonging to Group A developed laryngospasm and desaturation. Delayed Awakening was seen in one patient each of Group A, B and C. Overall, four complications were noted in patients of Group A, one in Group B and two in Group C. All complications were mild and were managed successfully.This preliminary study suggests that peri-operative anesthetic complications with all three anesthestic techniques were comparable and safe.
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Kim, Hye Jin, Chun-Gon Park, Yong Seon Choi, Yong Suk Lee, and Hyun-Jeong Kwak. "Effects of Anesthetic Techniques on the Risk of Postoperative Complications Following Lower Extremity Amputation in Diabetes Patients with Coagulation Abnormalities: A Retrospective Cohort Study Using Propensity Score Analysis." Journal of Clinical Medicine 10, no. 23 (November 28, 2021): 5598. http://dx.doi.org/10.3390/jcm10235598.
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Diabetic foot amputation is associated with high morbidity and mortality rates. To prevent cardiovascular complications along with vasculopathy in the course of diabetes mellitus, a high number of patients receive anticoagulant therapy. However, anticoagulants are contraindicated in neuraxial anesthesia limiting available anesthetic modalities. Therefore, in this retrospective study, we aimed to compare between general anesthesia and peripheral nerve block (PNB) with respect to postoperative complications following lower extremity amputation (LEA) in patients with coagulation abnormalities. In total, 320 adult patients who underwent LEA for diabetic foot were divided into two groups according to the anesthetic type (general anesthesia vs. PNB). The inverse probability of treatment weighting was performed to balance the baseline patient characteristics and surgical risk between the two groups. The adjusted analysis showed that compared with the general anesthesia group, the PNB group had lower risks of pneumonia (odds ratio: 0.091, 95% confidence interval [CI]: 0.010–0.850, p = 0.0355), acute kidney injury (odds ratio: 0.078, 95% CI: 0.007–0.871, p = 0.0382), and total major complications (odds ratio: 0.603, 95% CI: 0.400–0.910, p = 0.0161). Additionally, general anesthesia was associated with a higher amount of intraoperative crystalloid administration and a requirement for more frequent vasopressors. In conclusion, PNB appears to be protective against complications following LEA in diabetes patients with coagulopathy.
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Millar, Walter L. "Anesthesia for Postpartum Complications." Anesthesiology Clinics of North America 8, no. 1 (March 1990): 143–55. http://dx.doi.org/10.1016/s0889-8537(21)00159-0.
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Lindsey, Ronald W., and Allan Harper. "Complications of Regional Anesthesia." JBJS Case Connector 7, no. 4 (December 2017): e95-e95. http://dx.doi.org/10.2106/jbjs.cc.17.00279.
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Greensmith, J. Eric, and W. Bosseau Murray. "Complications of regional anesthesia." Current Opinion in Anaesthesiology 19, no. 5 (October 2006): 531–37. http://dx.doi.org/10.1097/01.aco.0000245280.99786.a3.
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Wolf, Steven. "Anesthesia and Perioperative Complications." Anesthesia & Analgesia 74, no. 6 (June 1992): 940???941. http://dx.doi.org/10.1213/00000539-199206000-00045.
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Mulroy, Michael F. "Complications of Regional Anesthesia." Anesthesia & Analgesia 89, no. 6 (December 1999): 1593. http://dx.doi.org/10.1213/00000539-199912000-00076.
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Liguori, Gregory A. "Complications of Regional Anesthesia." Journal of Neurosurgical Anesthesiology 16, no. 1 (January 2004): 84–86. http://dx.doi.org/10.1097/00008506-200401000-00018.
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Bouaziz, Hervé, and James C. Eisenach. "Complications of Regional Anesthesia." Anesthesiology 92, no. 6 (June 1, 2000): 1858. http://dx.doi.org/10.1097/00000542-200006000-00072.
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Rabinstein, Alejandro A. "Neurologic Complications of Anesthesia." CONTINUUM: Lifelong Learning in Neurology 17 (February 2011): 134–47. http://dx.doi.org/10.1212/01.con.0000394679.20738.9c.
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Entrup, Michael H., and Fred G. Davis. "Perioperative Complications of Anesthesia." Surgical Clinics of North America 71, no. 6 (December 1991): 1151–73. http://dx.doi.org/10.1016/s0039-6109(16)45581-7.
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Sharrock, Nigel E. "Complications of orthopedic anesthesia." Seminars in Anesthesia, Perioperative Medicine and Pain 15, no. 3 (September 1996): 288–94. http://dx.doi.org/10.1016/s0277-0326(96)80019-5.
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