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General Anesthesia
Anesthesia general

Images

WIKIDATA, CC BY-SA 2.5
WIKIDATA, CC0 1.0

Presentation

It is intended that the present case serve as a guide for fellow surgeons to identify and manage this syndrome. The present case was explained and a review of the literature was performed. [ncbi.nlm.nih.gov]

Entire Body System

  • Dentist

    PURPOSE: The purpose of this study was to explore the trends and utilization of general anesthesia services among board-certified pediatric dentists practicing in the United States. [ncbi.nlm.nih.gov]

    Most dentist anesthesiologists limit their practice to providing anesthesia services for other dentists who perform the necessary dental care. [asdahq.org]

    The ADA House of Delegates voted at its October 2016 meeting to adopt revisions to the guidelines concerning the use of sedation and anesthesia by dentists and teaching sedation and anesthesia to dentists and dental students. [ada.org]

    A permit shall be issued to an actively licensed dentist authorizing the use of general anesthesia or deep sedation at a specified practice location or locations on an outpatient basis for dental patients provided the dentist: Has completed a minimum [floridasdentistry.gov]

  • Hypoxemia

    Performing meta-analyses on hypertension, hypercapnia and hypoxemia was not possible. [ncbi.nlm.nih.gov]

    Hypoxemia and ischemia are potential etiologies of POCD for which potential treatments exist ( e.g ., supplemental oxygen), that were initially evaluated in the 1940s. 1 The first ISPOCD study examined the role of hypotension and hypoxemia as potential [anesthesiology.pubs.asahq.org]

    Adverse effects of residual neuromuscular blockade • Impaired airway protective reflexes • Upper airway obstruction • Impaired hypoxic ventilatory response • Postoperative hypoxemia • Symptoms and signs of profound muscle weakness • Swallowing disrupted [slideshare.net]

  • Hypothermia

    In turn this results in redistribution of body heat from core to periphery with subsequent rapid hypothermia during anaesthesia. [web.archive.org]

    A myotonic crisis can be induced by numerous factors including hypothermia, shivering, and mechanical or electrical stimulation. [ncbi.nlm.nih.gov]

    "Thermal insulation for preventing inadvertent perioperative hypothermia". The Cochrane Database of Systematic Reviews (6): CD009908. doi:10.1002/14651858.CD009908.pub2. [en.wikipedia.org]

    Severe hypothermia may result in coagulopathy, delayed awakening, or arrhythmia. [emedicine.medscape.com]

  • Sepsis

    The occurrence of peri-operative sepsis did not differ significantly between the study groups (13 of 117 patients in the MAC and 15 of 151 patients in the GA group; RR 1.23 (0.59 to 2.53); P = 0.580) (Additional file 12 ). [bmcmedicine.biomedcentral.com]

    Epidemiology of severe sepsis around the world. Endocr Metab Immune Disord Drug Targets. 2006; 6 :207–12. [ PubMed ] [ Google Scholar ] 44. Warden JC, Horan BF. Deaths attributed to anesthesia in New South Wales, 1984–1990. [ncbi.nlm.nih.gov]

    Factors that can decrease MAC (make the patient more sensitive) include increased age, hypothermia, pregnancy, sepsis, acute intoxication, concurrent IV anesthetics, and α2-adrenergic receptor agonists (for example, clonidine, dexmedetomidine). 18 19. [slideshare.net]

    […] hyperthermia.[42][43] Hospitals have procedures in place and emergency drugs to manage this dangerous complication.[44] Perioperative mortality[edit] Most perioperative mortality is attributable to complications from the operation, such as haemorrhage, sepsis [en.wikipedia.org]

Respiratoric

  • Hoarseness

    On the first postoperative day, she complained left sided tongue deviation, subtle hoarseness and swallowing difficulty. [ncbi.nlm.nih.gov]

    Also, some people have a sore throat or hoarseness from the breathing tube inserted after the person is unconscious. Inserting the breathing tube can sometimes cause damage to a person's mouth or teeth, but this is uncommon. [uwhealth.org]

Cardiovascular

  • Hypotension

    We administered ephedrine and phenylephrine to manage hypotension during general anesthesia. Immediately after the administration of these drugs, the ST segment elevated. [ncbi.nlm.nih.gov]

  • Thrombosis

    No arterial or deep vein thrombosis (DVT) was found prior to the surgery, but APE still occurred intraoperatively. [ncbi.nlm.nih.gov]

    A number of studies have reported a lower incidence of deep vein thrombosis (DVT), which is the forming of blood clots. Patients tend to wake up in the recovery room more smoothly and with less pain. [holycrossleonecenter.com]

    We conclude that spinal anesthesia is associated not only to low mortality indices, but also to a lower incidence of severe complications such as deep venous thrombosis, pulmonary embolism, pneumonia, respiratory depression, myocardial infarction, and [scielo.br]

    […] needed] Anaesthesiologists may administer an antiemetic agent such as ondansetron, droperidol, or dexamethasone to prevent postoperative nausea and vomiting,[citation needed] or subcutaneous heparin or enoxaparin to reduce the incidence of deep vein thrombosis [en.wikipedia.org]

Eyes

  • Lagophthalmos

    IntraVEnous anaesthesia and High-flow nasal oxygen (STRIVE Hi) is a technique that has been used in difficult and obstructed airways.[22] Eye management[edit] General anaesthesia reduces the tonic contraction of the orbicularis oculi muscle, causing lagophthalmos [en.wikipedia.org]

Psychiatrical

  • Distractibility

    METHODS: Twenty-four subjects of traumatic lower cervical spinal distraction-flexion were retrospectively analyzed from January 2010 to December 2013. [ncbi.nlm.nih.gov]

    Other factors frequently associated with incidents were inadequate communication among personnel, haste or lack of precaution, and distraction. [doi.org]

    Your anesthesiologist may ask you to count backward from 100 to distract you from any anxieties, in addition to helping them monitor how you are responding to the medication. [americanboardcosmeticsurgery.org]

Neurologic

  • Amnesia

    Under general anesthesia, the patient is unable to feel pain and may also have amnesia. [medicalnewstoday.com]

    These gases are supplemented with intravenous drugs designed to ensure amnesia (forgetfulness) and provide analgesia (pain control) after surgery. Many procedures require muscle relaxation to provide ideal surgical conditions. [northeasternanesthesia.com]

    It has 3 objectives: - Avoid pain; - Induce deep sleep and amnesia -- that is to say, a hypnotic state; - Induce muscle relaxation to make the surgeon's work easier. [youtube.com]

    General Anesthesia Reversible loss of consciousness Analgesia Amnesia Some degree of muscle relaxation 30. [slideshare.net]

  • Agitation

    It can also decrease postoperative pain and incidence of the emergence agitation. Due to the small number of studies, further clinical trials are needed to confirm these results. [ncbi.nlm.nih.gov]

    Ellerkmann, Postoperative Agitation im Kindesalter, Der Anaesthesist, 64, 5, (373), (2015). E. Ericsson, M. Brattwall and S. [doi.org]

  • Stupor

    Catatonia — Psychomotor disturbance characterized by muscular rigidity, excitement or stupor. Hypnotic agent — A drug capable of inducing a hypnotic state. [medical-dictionary.thefreedictionary.com]

    The terms anaesthesia (Greek: without feeling) and narcosis (Greek: stupor, paralysis) were introduced soon after the discovery of etherization. [bja.oxfordjournals.org]

    Opium was praised by the Persian philosopher and physician Avicenna in the eleventh century as the most powerful of stupor-producing substances. [encyclopedia.com]

  • Altered Mental Status

    General anesthesia or sedation can mask a hypoglycemia-altered mental status. Acute hypoglycemia might result in permanent brain injury. [ncbi.nlm.nih.gov]

Workup

Postoperative workup did not reveal any organic pathology. Unbeknown to the treating physicians, the patient had a comorbid untreated psychiatric history. [ncbi.nlm.nih.gov]

EEG

  • Burst Suppression

    Demographic data, indication for surgery, clinical history, history of prior seizures, duration of surgery and duration of burst suppression were recorded. Cases where seizures were observed were analyzed in detail. [ncbi.nlm.nih.gov]

Serum

  • Hypercapnia

    Severe hypercapnia is a rare but harmful complication of general anesthesia. We report the case of a newborn who developed severe hypercapnia with unknown reasons during general anesthesia but recovered well. [ncbi.nlm.nih.gov]

    • Cardiac arrhythmias: serious if hypercapnia develops due to hypoventilation and an increase in the plasma concentration of catecholamines) • Hypotensive effect (phenylephrine recommended) • Hepatotoxic: is oxidatively metabolized in the liver to tissue [slideshare.net]

  • Glucose Increased

    RESULTS: Resting energy expenditure (B1: 1230 ± 228; B2: 1317 ± 282; C: 1012 ± 153 kcal/h; B2 vs C, P CONCLUSIONS: The administration of amino acids and glucose increased measured energy expenditure, alleviated nitrogen balance, and may decrease the length [ncbi.nlm.nih.gov]

Treatment

Here we describe dental treatment under general anesthesia performed for a 28-year-old man with NS. He had characteristic features of NS along with mild pulmonary valve stenosis. [ncbi.nlm.nih.gov]

5 min. intervals iv Clonidine 0.15 mg iv Treatment Tramadol 1mg/kg iv Treatment or Prophylaxis Ondansetron 8mg iv Prophylaxis References 1. [web.archive.org]

Prognosis

The separation phenomenon of decrease in PETCO2 and increase in PaCO2 might be a useful and suggestive sign, enabling prompt management and therefore improving the prognosis. [ncbi.nlm.nih.gov]

Outlook (Prognosis) General anesthesia is generally safe because of modern equipment, medicines, and safety standards. Most people recover completely and do not have any complications. References Cohen NH. Perioperative management. [mountsinai.org]

Fetal prognosis after anesthesia during gestation. Analg. 42;521-6 Shnider, SM, Webster, GM. 1965. Maternal and fetal hazards of surgery during pregnancy. Am. J. Obstet. Gynecol. 92;891-900. Sylvester, GC, et al. 1994. [mothertobaby.org]

Etiology

The specific etiology of this condition is widely speculated. [ncbi.nlm.nih.gov]

The etiologic diagnosis of perioperative anaphylaxis relies on a triad including clinical, biologic, and allergologic evidence. Fig. 1. [doi.org]

Epidemiology

BACKGROUND: Epidemiological data demonstrate that the worldwide prevalence of chronic obstructive pulmonary disease is increasing. These patients have an increased risk of mortality and morbidity and have constant limitations in airflow. [ncbi.nlm.nih.gov]

In 2017, we have 47 ongoing studies among 27 investigators throughout our subspecialties, including clinical, bench, education, and epidemiological studies. [anesthesiology.cumc.columbia.edu]

This may have been a chance finding, as analyses did not adjust for multiple endpoints. 43 The PANDA study addressed many of the limitations of the previous epidemiologic studies. [fda.gov]

In fact, they have created their own section called Epidemiology and Safety. The other direction the Foundation went was to publish a quarterly Anesthesia Patient Safety Foundation Newsletter which has been immensely successful. [web.archive.org]

Pathophysiology

Early detection is even more difficult for patients under general anesthesia as common symptoms are not available and the pathophysiological course of intra-operative APE is influenced by procedures of surgery and anesthesia, which makes patients under [ncbi.nlm.nih.gov]

Pathophysiologic Elements Anaphylaxis occurring during the perioperative period is a clinical syndrome involving multiple organ systems. [doi.org]

The underlying pathophysiology of delirium in general, and PD specifically, remains elusive. [anesthesiology.pubs.asahq.org]

- Pathophysiological and clinical aspects of the CO2 pneumoperitoneum (CO2-PP). Surg Endosc, 1997;11:864-867. [ Links ] 13. [scielo.br]

Prevention

Effective management of ammonia levels in this patient using preoperative hydration and dexmedetomidine as an adjunct to general anesthesia may have helped to prevent delayed emergence. [ncbi.nlm.nih.gov]

The medicine will help to: Prevent pain Relax the muscles Stop certain reflexes Prevent awareness of what is happening Possible Complications Many steps are taken to prevent problems. [winchesterhospital.org]

Anesthesia specialists devote careful attention and use many methods to prevent this. [uwhealth.org]

You may be able to take medications to prevent it, and preventing it is typically easier than treating it. Shivering and chills: This typically lasts for a short time after surgery and goes away once you're awake and moving. [verywellhealth.com]

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