MANAGEMENT OF PERIOPERATIVE PULMONARY COMPLICATIONS

Abstract

Perioperative Pulmonary Complications (P.P.Cs) continue to be an important medical problem in modem practice of anesthesia. Researching this problem faces the . obstacle of the lack of a universally accepted and agreed upon definition of what constitute a P.P.C. Disturbed respiratory mechanics due to the combined effects of anesthetics, muscle relaxants, direct surgical trauma and postoperative pain appear to be responsible for the majority ofP.P.Cs.

Certain surgeries e.g.: thoracotomy and lung resection, cardiac surgery and upper abdominal procedures, are associated with increased incidence ofP.P.Cs.

Similarly, certain groups of patients e.g.: the elderly, smokers, morbidly obese and those with pre-operative pathologic chest conditions, carry increased risk for developing P.P.Cs.

Prevention of P.P.Cs entails early identification of high risk patient and optimizing their fitness for surgery. Application of ASA's monitoring standards by an attentive and vigilant anesthesiologist can lead to early recognition of respiratory mishaps, prompting active measures to abort further escalation of these problems.

Pulmonary aspiration of gastric contents, bronchospasm, ventilation/ perfusion mismatching, pneumothorax and