Anesthetic complications and emergencies and how to handle them (Proceedings)
The most effective way to deal with anesthetic emergencies is to prevent them and appropriate 1) stabilization of the patient, 2) selection of type and dosage of anesthetic drugs, 3) preparation of anesthetic equipment, 4) pre-, post- and intra-operative support of the patient, and 4) physiologic monitoring, will make the anesthetic episode safer and will decrease the likelihood of anesthetic emergencies. Anesthetic complications and emergencies can occur during any one of the four phases of anesthesia: premedication, induction, maintenance or recovery. Unfortunately, most unexpected anesthetic complications occur in recovery – and most of those occur because of failure to appropriately monitor and support the patient.
Anesthetic drugs must cause depression of the central nervous system (CNS) in order to produce sleep and, in general, anesthetic dugs also cause depression of cardiac output, arterial blood pressure, alveolar ventilation and oxygen delivery to the tissues. These changes in the CNS, cardiovascular and respiratory systems can become acutely life-threatening if depression is profound (eg, anesthetic overdose) or if the patient is debilitated (eg, patients in shock). Thus, we focus our monitoring and support on these three organ systems. Anesthesia-induced changes in other organ systems (eg, slowing of hepatic metabolism, decreased renal function) are not generally acutely life-threatening, although they can manifest as complications days to weeks postoperatively. Generally, support of the CNS, cardiovascular and respiratory systems provides support for other organ systems.
I. Central nervous system complications/emergencies
A. Treatment of CNS complications/emergencies?