What Are the Potential Complications of Anesthesia?

There are many anesthesia complications, such as apnea, upper airway obstruction, acute bronchospasm, atelectasis, pulmonary infarction, and pulmonary fat embolism. Here are some specific examples:

1. Apnea is commonly seen in patients who undergo intravenous general anesthesia without endotracheal intubation, especially when using thiopental, propofol, or ketamine for outpatient minor surgeries, ophthalmic surgeries, artificial abortions, and various endoscopic examinations. The clinical manifestations include the absence of respiratory movements in the chest and abdomen.

2. Upper airway obstruction can occur due to failed endotracheal intubation, extreme obesity, intravenous anesthesia without endotracheal intubation, aspiration of gastric contents, and laryngeal spasms. Patients often present with "three concavities" during spontaneous breathing, and prevention is essential. Immediate management is required if it occurs: placement of an oral or nasal airway or immediate artificial respiration.

3. Acute bronchospasm is more common in patients with a history of asthma or allergies to certain anesthetic agents. It can also be triggered by deep insertion of the endotracheal tube causing repeated stimulation of the carina, or by too shallow anesthesia during the induction phase. Patients exhibit extreme respiratory resistance, wheezing sounds throughout the lower lobes or the entire lung, and severe airway pressure abnormalities can lead to acute bronchospasm.

4. Atelectasis is often seen in patients after thoracic and upper abdominal surgeries. It is mainly caused by ineffective coughing and mucus blockage of the bronchi after surgery, and can also be related to unilateral bronchial intubation or regional atelectasis caused by inhaled anesthetics. Prevention includes smoking cessation for 2-3 weeks before surgery, avoiding bronchial intubation, effective analgesia after surgery, and encouraging patients to cough and take deep breaths.

5. Pulmonary infarction is more common in elderly patients who have been bedridden for a long time after pelvic or lower limb fractures. Prevention includes preoperative oral administration of aspirin for elderly patients with high blood lipid levels and high blood viscosity. Gentle movements are recommended when turning the patient after anesthesia induction.

6. Pulmonary fat embolism is commonly seen in elderly patients with long bone fractures undergoing intramedullary nail fixation or joint replacement. This complication occurs when instrumentation squeezes intramedullary fat, releasing large amounts of fat into the bloodstream, leading to widespread blockage of pulmonary microvasculature, acute elevations in pulmonary artery pressure, acute left heart failure, cyanosis, rapid blood pressure drops, and even cardiac arrest.