Injuries Associated with General Anaesthesia

Abstract

Airway management is an essential step during induction of general anaesthesia. Many tools can be used during airway management during general anaesthesia such as mask ventilation, nasal and oral airways, laryngeal mask airway and endotracheal tube. Injury of the airway could occur either due to patient related factors or anaesthesia related factors. Airway injuries includes lip injury, dental injury, tongue injury, nasal injury, temperomandibular joint injury, pharyngeal injury, laryngeal and vocal cords injury, arytenoid injury, tracheobronchial injury, Lung and oesophageal injury. Proper positioning for the surgical procedure during general anaesthesia is an essential step that has to be carried out with great caution. The commonly adopted positions during general anaesthesia include; supine position, trendlenburg position, lithoyomy position, lateral decubitus position, sitting position and prone position. On assumption of any of those positions there are certain pathophysiological changes that occur to the patients. Knowledge of physiological changes associated with the position can help predict potential problems and prevention of many complications. Muscular and cutaneous injuries during general anaesthesia often have a delay in appearance, that's why they are often overlooked or not linked to the surgical procedure. They could be either of mechanical origin or secondary to burn. Predisposing injuries for mechanical injuries include old age, malnutrition and chronic diseases such as diabetes mellitus and hypertension. Mechanical injuries could occur due to pressure, friction or shear stress. It includes pressure ulcers, reactive hyperemia, alopecia and tourniquet related injuries. Muscular and cutaneous injuries due to burn could occur due to electrical, thermal or chemical burn. Postoperative patient's transportation carries many risks such as risk of fall, technical complications as displacement of endotracheal tubes or even pathophysiological deteriorations especially with inadequate monitoring. There are general precautions during patient's transportation that could minimize the incidence of complications. During transportation of mechanically ventilated patient, morbidely obese patient, cardiac patient and poly-traumatized patients, in addition to the general precautions, there are other special precautions specific for each one of those patients.