Diplopia as a complication of local anesthesia: A case report
Anesthesia and its complication
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Transcript of Anesthesia and its complication
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Anesthesia and its Complication
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Potential complication related to hazardous drug interactions
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1. Antibiotics and curariform muscle relaxant
Ex: Neomycin SO4 streptomycin SO4polymycin A and B SO4
colistin SO4kanamycin SO4.
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2. antidepressants
MAO (monoamine oxidase) inhibitors
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3. diuretics
thiazides
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4. antihypertensives
ReserpineHydralazinemethyldopa
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5. anticoagulants
HeparinCoumadin
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6. aspirin
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7. steroids
cortisone
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GA
1. CARDIAC ARREST
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GA
2. RESPIRATORY DEPRESSIONa. Excessive mucusb. CNS depressionc. Bronchospasm/
laryngospasm
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GA
3. HYPOTENSION AND SHOCK
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GA
4. LOSS OF PROTECTIVE RESPONSE TO PAIN
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GA
5.VOMITING AND ASPIRATIONS
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GA 6.
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GA
7. Malignant hyperthermia: possible
treatment with dantrolene
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Treatment of Complications
Establish an open airway.Give oxygen.Notify the surgeon.Fast-acting barbiturate is usual
treatment. If toxic reaction is untreated,
unconsciousness, hypotension, apnea, cardiac arrest, and death may result.
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RACOMPLICATIONS
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RA
1.Anaphylaxis Immunologic sensitization methylparaben
Overdosage Hazardous site:▪ Vascular: Tracheobronchial
mucosa▪ Tissue: head, neck,
paravertebral.
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RA
1.HYPOTENSION
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Mgt:
PREVENTION: Infuse 500-800 mL of IV
if not prone to CHFINTERVENTION: Oxygen administration Vasoconstrictive drugs Trendelenburg position
10-20 mins after induction
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PREVENTION:Avoid extreme trendelenburg position before level of anesthesia sets
INTERVENTION:Artificial airway
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Mgt:
2.NAUSEA AND VOMITINGINTERVENTION: Oxygen administration Give ephedrine, anti-
emetics IVF
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RA
3.HEADACHE – excessive loss of CSF due to:a.Loss of large
spinal fluidb.Poor hydration
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PREVENTION:Use of small needleAdminister IV before and after induction
Keep well hydrated to aid in spinal fluid replacement.
inject client blood to plug the hole (10cc)
Flat on bed for 6 to 8 hours
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INTERVENTION:Apply tight abdominal binder
IV administrationAnalgesic
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RA
4.Overdosage
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Complications/ Discomforts of Regional Anesthesia:
5. RESPIRATORY PARALYSIS – happens when drug reaches upper thoracic and cervical cord in large amount or in heavy doses
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6. Neurological Complication- maybe due to:a. unsterile needle, syringes or anesthetic agentb. per-existing disease of CNSc. transient response to anestheticsd. position during surgery
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Mgt:
supportive care for transient forms
antibiotic and steroid therapy
rehabilitation for permanent paralysis
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RAS/S By systems
The side effects of local anesthetics Local effects- local irritation and skin
breakdown CNS effects if systemic absorption
occurs- headache, restlessness, anxiety, dizziness, tremors and blurred vision.
GI system- nausea, vomiting Cardio- arrhythmias, peripheral
vasodilation, myocardial depression, and rarely, cardiac arrest
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ANY QUESTION?