Some diseases can be treated by taking medicine or injecting drugs, but some diseases may require surgical treatment, and some harmful wounds also require surgical treatment, so surgery is an indispensable part of current medical treatment. This treatment method generally requires anesthesia for surgery. So, are there any adverse symptoms after general anesthesia?
1. Respiratory system complications
1. Tongue dropback
Cause: The effect of anesthetic drugs has not completely disappeared after general anesthesia. After extubation, the mandible and The tongue muscles relax, and the tongue body falls back due to gravity, blocking the upper respiratory tract.
Prevention: When the patient is fully awake and the gag reflex and cough reflex have fully recovered, remove the tracheal tube, turn the patient's head to one side, and hold up the mandible.
Treatment: Immediately lift the mandible and inhale pure oxygen to assist or control breathing, and place an oropharyngeal or nasopharyngeal airway.
2. Respiratory secretions, bloody sputum and foreign matter block the respiratory tract
Reason: respiratory secretions increase after general anesthesia, blood oozing, residual tissue and blood clots after oral and nasopharyngeal surgery, Lung disease and post-operative reflux or necrotic tissue in the trachea and bronchus.
Prevention: Carefully remove secretions from the oropharynx and nasal cavity before removing the endotracheal tube.
Treatment: Immediately insert a laryngoscope and remove foreign bodies, pus and blood clots, necrotic tissue, etc. under bright vision. At the same time, use a mask to inhale oxygen, artificial ventilation or high-frequency jet ventilation to maintain good blood oxygen saturation. Prevent cardiac accidents. If the patient is unstable or comatose, tracheal intubation should be performed immediately and mechanical ventilation should be performed.
3. Laryngospasm
Cause: caused by oropharyngeal blood sputum and secretions irritating the glottis, induced by hypoxia and carbon dioxide accumulation, caused by direct irritation of the glottis by a sputum suction tube, the original Have a history of respiratory tract inflammation or asthma.
Prevention: Prevent irritation caused by the reflux of tracheal secretions and gastric contents, avoid direct stimulation from the sputum suction tube, use gentle movements, and promptly aspirate oropharyngeal secretions after anesthesia is completed to avoid awake operations. Those with allergies were given dexamethasone 10mg.
Treatment: Remove the cause, inhale oxygen by mask, intravenously inject diazepam 0.2mg/kg, dexamethasone 10mg, and in severe cases, perform cricothyroid membrane puncture and high-frequency jet ventilation. Apply intravenous injection of 100 mg of muscle relaxant succinylcholine to quickly relieve laryngospasm.
2. Circulatory system complications
1. Postoperative hypotension
Cause: The patient's cardiac function is insufficient, and the cardiac output cannot maintain normal status. Blood volume, insufficient intraoperative transfusion. Hypoglycemia, hypoxemia. Adrenocortical insufficiency, postoperative pheochromocytoma. The effects of general anesthetic drugs have not completely worn off.
Prevention: Maintain normal blood volume and replenish blood components. Improve heart function and keep it in a normal state. Supplement blood sugar and adrenal cortical hormones.
Treatment: Replenish blood volume in time, maintain good ventilation, and keep the airway open. Patients with adrenocortical insufficiency were given dexamethasone 30 mg. For patients with metabolic acidosis, 100ml of 5% NaHCO3 should be injected intravenously before increasing blood pressure, and the dosage should be determined based on blood gas. As a vasopressor, 15-30 mg of ephedrine can be used intravenously. When the effect is not good, dopamine can be used to support cardiac function.
2. Causes of postoperative hypertension: original history of hypertension, stimulation by sputum suction and extubation, hypercapnia or hypoxemia, postoperative nausea and vomiting causing sympathetic nerve excitement, pain and chills .
Prevention: General anesthesia plus epidural anesthesia or nerve block, use sedatives and analgesics without affecting ventilation, reduce sputum suction stimulation, and extubate quickly.
Treatment: Remove the inducement, apply urapidil 0.5mg/kg, and apply nitroglycerin to the elderly and infirm. If high blood pressure is accompanied by fast heart rate, give esmolol 0.25 mg/kg, and pay attention to monitoring blood pressure and heart rate.
3. Reasons for delayed anesthesia recovery
Anesthetic drug overdose, hypoxemia, hypothermia during anesthesia, glucose metabolism disorder and water and electrolyte metabolism disorder.
Prevention: Correct anemia, sugar, water and electrolyte disorders before surgery, strengthen monitoring during surgery, and avoid overdose of anesthetic drugs.
Treatment: Due to overdose of inhaled anesthetics, ventilation should be increased to promote discharge; due to overdose of intravenous anesthetics, infusion should be accelerated; at the same time, antagonists such as nalmefene and neostigmine should be applied.
4. Renal complications
1. Oliguria
Cause: Prerenal is due to renal hypoperfusion caused by hypovolemia; renal is due to Tubular necrosis caused by hypoperfusion, toxins, and trauma; postrenal due to urinary tract obstruction.
Treatment: 200-300ml of crystalloid can be quickly infused without using diuretics first.
2. Polyuria
Cause: Too much infusion , application of diuretics; loss of renal tubular concentrating function, osmotic diuresis caused by mannitol, etc.
Treatment: Treat symptomatically according to the cause.
5. Causes of nausea and vomiting
History of motion sickness, previous history of vomiting during anesthesia, use of opioids, female.
Management: Preventing gastric distension and good postoperative analgesia can prevent postoperative malignant vomiting and avoid hypotension and hypotension; perioperative application of haloperidine can reduce the incidence of nausea; methoxy Chloropramide accelerates gastric emptying and has central antiemetic effects.
6. The reason for agitation during the recovery period
Mainly is insufficient postoperative analgesia.
Treatment: Take postoperative analgesia (intravenous or epidural), and pay attention to the patient's breathing, blood pressure and blood oxygen.
7. Reasons for postoperative hypothermia and shivering
A large amount of blood and fluid transfusions are required during the operation; the operation time is long, and it is easy to occur during chest and abdominal surgery.
Treatment: Input rewarmed stock blood. When a large amount of infusion is required during the operation, it should be heated to 36-37 degrees. The operating room temperature should be maintained at 25-28 degrees. A heating blanket should be used for longer operations. .
8. Summary
The anesthesia recovery period is very important for patients. Close observation and monitoring of patients should be carried out until the patient’s vital signs return to stability to prevent and early detect complications after anesthesia. symptoms and ensure that patients return to the ward safely after surgery.
9. What are anesthetics?
Anesthetics refer to drugs that can cause the entire body or part of the body to temporarily and reversibly lose consciousness and pain. According to their scope of action, they can be divided into general anesthetics and local anesthetics. The effects and side effects of anesthetics are very short-lived, and generally there will be no sequelae unless serious accidents occur. So let’s take a look at the side effects of using anesthetics.