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At least 91 records · Page 5Linked to original sources
PubMed2003

Anesthesia related complications of laparoscopic cholecystectomy.

OBJECTIVE: To determine the incidence of intraoperative anesthesia-related complications of laparoscopic cholecystectomy. DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: The study was conducted in Anesthesia Department of Hayat Shaheed Teaching Hospital, Peshawar from April 1995 to April 1996. SUBJECTS AND METHODS: One hundred consecutive patients (ASA I and ASA II) were anesthetized and monitored intraoperatively for detection of complications. The operative findings and data were recorded on a proforma and finally the results were analyzed. RESULTS: One hundred patients with male to female ratio of 1: 8.09 in the age range of 20-80 years (mean 39 years) underwent general anesthesia for laparoscopic cholecystectomy. The duration of operation in 94 laparoscopic cholecystectomy was from 20 to 80 minutes (mean 60.63 minutes ).The incidence of intraoperative hypotension was 9%. Four percent of the patients developed arrhythmias. Increase in end-tidal-carbon dioxide (ETCO2) was observed in 3% of cases. Conversion rate to open cholecystectomy was 6%. Damage to intraabdominal vessels with trocar insertion occurred in 1% of cases. CONCLUSION: Although laparoscopic cholecystectomy has major surgical and anesthetic advantages, there are anesthesia related complications requiring specific anesthetic interventions to improve patients outcome without compromising their safety.

Adult↗
PubMed1999

Placenta previa: a 22-year analysis.

OBJECTIVE: Our purpose was to identify what anesthetic method is safer for women with a placenta previa. STUDY DESIGN: We retrospectively reviewed all women with placenta previa who underwent cesarean delivery during the period January 1, 1976-December 31, 1997 at Northwestern Memorial Hospital. RESULTS: Of 93,384 deliveries, placenta previa was found in 514 women. Identifiable trends with time included an increasing incidence of placenta previa (r = 0.54, P <.01); cesarean hysterectomy (r = 0.54, P <.01); placenta accreta (r = 0.45, P <.03); and regional anesthesia (r = 0.84, P <.0001). The mean gestational age at delivery was 35.3 +/- 3.4 weeks and did not change with time. General anesthesia was used for delivery in 380 women and regional anesthesia was used for 134 women. Prior cesarean delivery and general anesthesia were independent predictors of the need for blood transfusion, but only prior cesarean delivery was a predictor of the need for hysterectomy. General anesthesia increased the estimated blood loss, was associated with a lower postoperative hemoglobin concentration, and increased the need for blood transfusion. Elective and emergent deliveries did not differ in estimated blood loss, in postoperative hemoglobin concentrations, or in the incidence of intraoperative and anesthesia complications. Regional and general anesthesia did not differ in the incidence of intraoperative and anesthesia complications. CONCLUSIONS: In women with placenta previa, general anesthesia increased intraoperative blood loss and the need for blood transfusion. Regional anesthesia appears to be a safe alternative.

Adult↗
PubMed1991

Perioperative complications of anesthesia.

An overview of several perioperative complications and their management strategies is presented. Operative hypothermia, malignant hyperthermia, bronchospasm, and side effects of spinal opioid agents are discussed. Ramifications of these complications may extend well beyond the operative period and influence patient outcome. Therefore, it is necessary that the surgeon have a fundamental understanding of the pathophysiology and modalities of treatment in the context of anesthesia and surgery.

Anesthesia↗
PubMed1997

[Peridural abscess complicating spinal anesthesia in a diabetic patient].

Infectious complications of spinal or epidural anaesthesia are rare, particularly after spinal anaesthesia. Most of them consist of a meningitis. We report a case of epidural abscess due to Staphylococcus aureus following spinal anaesthesia in a 62-year-old diabetic patient, diagnosed 45 days after the puncture with bacterial samples and magnetic resonance imaging. The pejorative neurological outcome required a laminectomy in spite of an efficient anti-staphylococcal treatment.

4-Quinolones↗
PubMed2006

Anesthesia-related complications in children.

BACKGROUND: Careful preoperative assessment and adequate planning of an appropriate anesthetic are the cornerstones safe pediatric anesthetic practice. A prospective study was carried out in pediatric surgical patients to identify and quantitate both intra-operative and post anesthesia recovery room complications, management and outcome. METHODS: Two hundred and seventy children, aged day 1-16 years who had surgery over twelve months period were recruited in the study. There were 151 males (56%) and 119 females (44%). There were 15 neonates (5.5%), 69 infants below 1 year (25%), 99 (36.7%) toddlers and younger children (1-5 years); older children >5 years were 87 (32.2%). Anesthetists managing the patients were free to use drugs and technique they considered appropriate for each patient. A standardized form was used to collect patient's details, type of surgery, technique of anesthesia, duration of anesthesia and surgery. The incidence of intra-operative and post-anesthesia recovery room complications was determined. RESULTS: Twenty five intraoperative complications were recorded in 14 (5.1%) patients while forty postoperative complications were recorded in 25 (9.25%) patients. The incidence of intraoperative complications was 9.3% while that of postoperative complications was 14.8%. There were no statistically significant differences. P = 0.0635, Odds ratio = 0.5867, 95% CI: 0.3449 - 0.9981. Intraoperative adverse events were mainly cardiovascular and respiratory. After cardiovascular complication, pain was the second commonest postoperative complication observed in the recovery room. Occurrence of complication was not related to ASA physical status but the outcome of management of complications was directly related to ASA status. Three preterm infants weighing 1.6 kg, 1.9 kg and 2 kg respectively were transferred to Intensive Care Unit for ventilatory support. Neonates and infants < below 12 months old had the highest rate of adverse events both intraoperatively and in the postanesthesia recovery room. There were two cases of cardiac arrest. Mortality rate was 0.34%. CONCLUSION: Preterm infants are more prone to developing respiratory complications. Anesthesia-related morbidity and mortality can either be minimized or avoided with early identification and prompt management of any complication.

Adolescent↗
PubMed1983

Video stethoscope--a simple method for assuring continuous bilateral lung ventilation during anesthesia.

Complications of endotracheal intubation and mechanical ventilation are infrequent but important causes of intraoperative morbidity and mortality. We have developed a simple method of monitoring the ventilation of both lungs during general anesthesia and have evaluated this technique in 25 patients undergoing surgery under general anesthesia. A small plastic electrocardiographic electrode casing fitted with a microphone was affixed to the skin overlying each hemithorax in a location where preliminary auscultation showed that breath sounds could be heard. The sounds from each microphone were amplified and displayed on an oscilloscope screen in an X-Y format. The patterns seen on the screen allowed easy identification of right mainstem intubation, esophageal intubation, or proper endotracheal tube placement. This preliminary study suggests that our technique is feasible and provides more information about the position of the endotracheal tube than presently used methods.

Anesthesiology↗
PubMedDate not supplied

Bilateral chronic subdural hematomas with neurologic symptoms complicating spinal anesthesia.

BACKGROUND AND OBJECTIVES: Intracranial subdural hematoma is a rare but potentially fatal complication of spinal anesthesia (SA). This case is intended to highlight the importance of careful follow-up of patients with a chronic headache that develops after SA. CASE REPORT: A 38-year-old woman underwent saphenous vein ligation for varices under SA. On the first postoperative day, she complained of severe postural headache that was controllable with oral analgesics. Two weeks later, bilateral abducens nerve palsy with diplopia developed. Brain magnetic resonance imaging (MRI) showed small bilateral subdural hygromas. Diplopia and headache (no longer postural) were relieved after administration of dexamethasone, but reappeared 6 wks later. This time, MRI showed large subdural hematomas. The patient was treated with burr-hole decompression. CONCLUSIONS: Persistent headache after SA requires careful neurologic and radiologic follow-up for exclusion of chronic intracranial bleeding. Pharmacologic treatment may mask some neurologic symptoms and delay diagnosis of intracranial complications related to SA.

Abducens Nerve Injury↗
PubMedDate not supplied

[Complications of anesthesia and means of lowering their frequency].

Retrospective analysis of 9262 formalized case histories has been made to compile a protocol of anesthesia. Each blank contains 223 items describing the patient and is intended for retrospective computer analysis of the information. Phases of the complications onset have been established and a working classification of complications has been suggested. Organization measures, which reduced the frequency of complications by 2.4% have been elaborated. The factors that increase the frequency of anesthesia-induced complications are reviewed.

Anesthesia↗
PubMed1997

[Infectious complications after peridural obstetric anesthesia].

Infective complications after epidural anesthesia for delivery are uncommon. We reviewed 21 cases of epidural abscesses, 7 cases of meningitis and one spondylitis reported in the literature. These infections usually occurred in debilitated patients either by direct contamination at puncture or indirectly from a neighboring infection or from the blood stream. Prognosis depends on early diagnosis. The first manifestations are spinal stiffness or local pain. Signs of neurological deficiency come later at a stage when complete recovery is compromised. This emphasizes the importance of the clinical examination before delivery in search for skin or deep infections.

Abscess↗
PubMed1992

Anesthesia and complications of extracorporeal shock wave lithotripsy of urinary calculi.

The techniques of anesthesia for extracorporeal shock wave lithotripsy of urinary calculi and the associated complications in 600 treatments with the second generation lithotriptor Siemens Lithostar were studied. General anesthesia was used in 17 treatments (2.8%) and epidural anesthesia was applied in 73 (12%), primarily in children and patients in need of simultaneous surgical auxiliary procedures. A total of 510 treatments (85%) was performed with a combination of local infiltration anesthesia and supplementary intravenous opiates. In 65% of the cases only 2 injections of opiates were sufficient for pain relief. There were no complications in 394 treatments (77%) and minor complications, such as arrhythmia (9.2%) and nausea/vomiting (7.6%), were easily treated. Respiratory depression was observed in 10 cases (2%) and this potentially dangerous complication was associated with simultaneous administration of opiates and midazolam. Only 9 treatments (1.8%) had to be terminated due to complications. It is concluded that most treatments of urinary calculi with this second generation extracorporeal shock wave lithotriptor can be performed with local infiltration anesthesia combined with supplementary short-acting opiates intravenously for pain relief and sedation. When administering supplementary midazolam for sedation the risk of respiratory depression should be considered.

Adolescent↗