Reflux and aspiration are easy to occur during general anesthesia, especially in obstetric and pediatric surgical patients. Because of the different nature and quantity of reflux or aspiration, the consequences are different. During the induction of general anesthesia, the patient's consciousness and laryngeal reflex disappear, and once there is reflux, aspiration can occur. Whether the inhaled substance is solid food or gastric juice, it will cause acute respiratory obstruction. Complete airway obstruction can immediately lead to asphyxia and hypoxia, endangering the life of patients. It is very important to prevent reflux and aspiration during anesthesia. The main measures include reducing the retention of gastric contents, promoting gastric emptying, improving the pH value of gastric juice, reducing gastric pressure and strengthening respiratory protection.

Second, airway obstruction.

Third, insufficient ventilation.

Insufficient ventilation can occur during and after general anesthesia, mainly manifested as carbon dioxide retention and may be accompanied by hypoxemia. Blood gas analysis showed that PaC02 was higher than 50mmHg and pH was lower than 7.30. The injury of brain surgery and the residual effects of general anesthetics, narcotic analgesics and sedatives are the main reasons for central respiratory depression. Breathing should be maintained by mechanical ventilation until the respiratory function is completely restored, and it can be reversed by antagonists if necessary. The residual effect of muscle relaxant after operation can lead to insufficient ventilation. Breathing should be assisted or controlled until the respiratory muscle strength is fully recovered, and antagonists should be given if necessary.

Fourth, hypoxemia

The clinical manifestations are shortness of breath, cyanosis, restlessness, tachycardia, arrhythmia and elevated blood pressure. The common causes and treatment principles are as follows: ① the failure of anesthesia machine and insufficient oxygen supply can lead to low inhaled oxygen concentration; Insertion of tracheal catheter into one bronchus, tracheal eversion and airway obstruction can cause hypoxemia, which should be found and corrected in time. Diffuse hypoxia can be seen in N2O inhalation anesthesia. Stop inhaling N2O and continue inhaling oxygen for at least 5 ~ 10 minutes. ③ atelectasis can be corrected by sputum aspiration, increasing ventilation and lung recruitment. ④ Oxygen therapy is effective for mild inhalers, and mechanical ventilation should be performed for severe inhalers. ⑤ Acute left heart failure or increased pulmonary capillary permeability may lead to pulmonary edema. While increasing the concentration of inhaled oxygen, we should actively treat the primary disease.

Verb (abbreviation for verb) hypotension

During anesthesia, the systolic blood pressure drops more than 30% of the basic value, and those whose absolute value is less than 80mmHg should be treated in time.

Sixth, hypertension.

During anesthesia, the diastolic blood pressure is higher than 100mmHg or the systolic blood pressure rises more than 30% of the basic value, which should be treated according to the reasons.

Seven, arrhythmia

When sinus tachycardia and hypertension occur at the same time, it is often a manifestation of shallow anesthesia, and anesthesia should be deepened appropriately. When there are hypovolemia, anemia and hypoxia, the heart rate can increase rapidly, and treatment should be carried out according to the cause. When visceral organs (such as gallbladder) are pulled by surgery or eye-heart reflex occurs, vagus nerve reflex can cause bradycardia and even cardiac arrest in severe cases. The operation should be stopped in time and atropine should be injected intravenously if necessary. When premature beats occur, we should first make clear its nature and observe its influence on hemodynamics. Ventricular premature beats caused by shallow anesthesia or CO2 accumulation can be relieved by properly deepening anesthesia or expelling CO2. If ventricular premature beats are multi-source, frequent or accompanied by R-on-T phenomenon, it means that myocardial perfusion is insufficient and should be treated in the past.

Which of the following is the complication of general anesthesia?

A. Reflux and suction

B. airway obstruction

C. arrhythmia

D. Hypertension

E. hypotension

Answer ABCDE.