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PubMed1980

[Complications of subarachnoid anesthesia].

Complications and accidents in subarachnoid anaesthesia, their frequency, and methods for their prevention are described. Reference is also made to a personal series in which the low incidence of untoward consequence was probably attributable to the precautions described.

Adult↗
PubMedDate not supplied

[Complications and side effects of spinal anesthesia].

Complication and side effects of spinal anesthesia have been studied in 2603 patients. The following complications of spinal anesthesia have been observed: transient and prolonged arterial hypotension; marked respiratory and circulatory depression; neurological consequences and early and late respiratory depression associated with intrathecal administration of narcotic analgesics. Side effects comprised vomiting, nausea, transitory urination disturbances, and itching. The dependence of the number of complications and side effects on the level of puncture, the patient's age and concentration of the anesthetic introduced into subarachnoidal space has been established.

Adolescent↗
PubMed2005

Complications of anesthesia for cesarean delivery.

OBJECTIVE: To quantify anesthesia-related complications associated with cesarean delivery in a well-described, prospectively ascertained cohort from multiple university-based hospitals in the United States and to evaluate whether certain factors would identify women at increased risk for a failed regional anesthetic. METHODS: A prospective observational study was conducted of women (n = 37,142) with singleton gestations undergoing cesarean delivery in the centers forming the National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Detailed information was collected regarding choice of anesthesia and procedure-related complications, including failed regional anesthetic and maternal death. Potential risk factors for a failed regional anesthetic were analyzed. RESULTS: Of the women studied, 34,615 (93%) received a regional anesthetic. Few (3.0%) regional procedures failed, and related maternal morbidity was rare. Increased maternal size, higher preoperative risk, rapid decision-to-incision interval, and placement later in labor were all significantly related to an increased risk of a failed regional procedure. Of the general anesthetics, 38% were administered when the decision-to-incision interval was less than 15 minutes. Women deemed at the greatest preoperative risk (American Society of Anesthesiologists score > or = 4) were approximately 7-fold more likely to receive a general anesthetic (odds ratio 6.9, 95% confidence interval 5.83-8.07). There was one maternal death, due to a failed intubation, in which the anesthetic procedure was directly implicated. CONCLUSION: Regional techniques have become the preferred method of anesthesia for cesarean delivery. Procedure-related complications are rare and attest to the safety of modern obstetric anesthesia for cesarean delivery in the United States.

Adolescent↗
PubMed1992

Brain-stem anesthesia as a complication of regional anesthesia for ophthalmic surgery.

Brain-stem anesthesia is a serious complication of orbital regional anesthesia that may occur when the injected local anesthetic agent gains access to the central nervous system by direct spread from the apex of the orbit via submeningeal pathways. In most studies the reported incidence rate during retrobulbar block is one case per 350 to 500 patients. Failure to recognize the condition or to treat it adequately may be life threatening. Treatment includes reassurance, intravenous administration of fluids, pharmacologic circulatory support or suppression of convulsions, and cardiopulmonary resuscitation. With proper treatment complete recovery is the rule. In all situations in which orbital block is to be done, basic cardiopulmonary resuscitation equipment and personnel familiar with its use are essential. Monitoring of the blood pressure, electrocardiography and pulse oximetry should be routine. Having the globe in primary gaze renders the optic nerve less vulnerable, and avoidance of deep penetration of the orbit is of great importance.

Anesthesia↗
PubMed1989

[Epidural hematoma following peridural anesthesia].

Complications of epidural anesthesia are uncommon, but lesions are possible without technical failure. Neurological symptoms increase progressively with spinal cord compression; early recognition and treatment are imperative. Operative decompression is in most cases the only therapeutic option. This case report aims to call attention to the possibility of epidural hematoma following epidural anesthesia.

Anesthesia, Epidural↗
PubMed1992

[Total spinal anesthesia. A complication of lumbar catheter peridural anesthesia for postoperative analgesia].

A case of secondary subarachnoidal dislocation of a lumbar epidural catheter is reported. A 76-year-old female underwent resection of the sigmoid colon. In order to provide postoperative analgesia, an epidural catheter was inserted between the 3rd and 4th lumbar interspaces prior to induction of anaesthesia. Aspiration tests were negative twice and a test dose of 4 ml 0.5% bupivacaine produced no signs of anaesthesia. Thereafter, the operation was performed under balanced general anaesthesia. Prior to the end of surgery a total of 14 ml bupivacaine 0.5% was administered without significant cardiovascular depression. At the time of extubation the patient was awake and free of pain. There was no sign of respiratory depression or paralysis of the upper extremities. Three hours later in the recovery room the patient complained of pain. After a negative aspiration test 14 ml bupivacaine 0.25% was injected. Thirty minutes after injection apnea and cardiac arrest occurred. Resuscitation was immediately started, resulting in quick restoration of circulation and restitutio ad integrum. Aspiration at this time showed cerebrospinal fluid. The latency of the onset of total spinal anaesthesia and the rapid restoration of stable vital functions, was astonishing. It is essential to observe the common precautions such as an aspiration test without a filter, administration of a test dose, and titration of the injected amount each time the anaesthetic agent is applied via an epidural catheter.

Aged↗
PubMed2000

Complete paraplegia as a result of regional anesthesia.

Complications after spinal or epidural anesthesia are rare. We report 2 cases of postoperative, complete paraplegia after regional anesthesia in orthopaedic patients not on anticoagulants. The paralysis was likely the result of spinal cord compression secondary to an epidural hematoma in 1 case and subdural hematoma in 1 case. A review of the literature regarding complications of regional anesthesia is presented. Regional anesthesia should be administered with caution and in selected patients.

Aged↗
PubMed2004

Frequency of anesthesia-related complications in children with Down syndrome under general anesthesia for noncardiac procedures.

BACKGROUND: Craniofacial and cardiac anomalies of Down syndrome (DS; trisomy 21) would seem to place these patients at higher risk of anesthesia-related complications (ARCs), but to date no comprehensive large-scale study has quantified this risk. METHODS: A retrospective chart review was conducted on all patients with DS undergoing anesthesia between April 1, 1988, and May 31, 1995, at Children's Hospital of Pittsburgh. In addition, the Anesthesiology Department Quality Assurance (QA) System database of concurrently collected anesthesia information on all patients undergoing anesthesia at the hospital since 1985 was analyzed. RESULTS: Of the total 74,021 anesthetic encounters during the study period, 930 anesthetic encounters in 488 patients with DS undergoing noncardiac procedures were analyzed. The most frequent ARCs were bradycardia (severe) (3.66%), natural airway obstruction (1.83%), difficult intubation (0.54%), postintubation croup (1.83%), and bronchospasm (0.43%). CONCLUSIONS: Comprehensive reporting is needed to capture all significant adverse events. The incidences of bradycardia on induction, natural airway obstruction, and postintubation (or instrumentation) croup were significantly higher in the DS noncardiac group compared with the remaining population. Current anesthesia techniques and agents must be compared using quantitative QA data to ensure use of the safest options for each patient.

Academic Medical Centers↗
PubMed2005

An audit of postoperative minor complications of anesthesia.

OBJECTIVE: To look at minor complications attributable to anesthesia in adult surgical patients at our Institution and to identify various contributing factors. DESIGN: Descriptive cross sectional audit. SETTING: Aga Khan University Hospital, Karachi, Pakistan. STUDY PARTICIPANTS: Seven hundred and thirty surgical patients undergoing elective surgery were recruited. INTERVENTIONS: This was a non-interventional study and data was collected prospectively based on predefined criteria. MAIN OUTCOME MEASURES: The incidence of nausea, vomiting, sore throat, headache, drowsiness, phlebitis, dizziness, myalgia, transient nerve palsy, conjunctivitis, ringing of ears, low backache, lip injury, dental injury or any other minor complications were looked at. RESULTS: Nausea, sore throat and vomiting were the highest reported complications. The incidence of nausea, drowsiness and dizziness was less in patients more than sixty years of age. Incidence of nausea and vomiting was higher in ASA 1 patients and in surgery lasting less than ninety minutes. Headache and dizziness were reported high in certain surgical specialties. CONCLUSION: The overall rate of minor complications following anesthesia was 12.6%. No complications were reported by 30% of the study population. The data has given us a benchmark for patient information and will be used for risk reduction in our Department of Anaesthesiology.

Adult↗
PubMedDate not supplied

Prevention of venous complications from intravenous anesthesia.

Vascular complications following the use of intravenous sedative drugs continue to be a problem in dental anesthesia. Etiological factors associated with pain and thrombophlebitis are reviewed. From reports in the literature and clinical experience, venous complications from intravenous sedation may be reduced by utilizing large veins with the dilution of sedative agents in a fast running intravenous infusion. Intravenous lidocaine may be of use to block reflex venospasm and pain.

Anesthesia, Intravenous↗