Surgical Complications

Any time you are to undergo anesthesia and surgery there is the possibility even though it is remote of experiencing a complication.  This is a fact of like we all have to consider when we decide to undergo any surgical procedure.  In the old days of surgery and anesthesia only 30 to 40 years ago this was a common occurrence.

Perioperative risk is dependent on many factors and is related to anesthesia, the patient and surgical factors.  In terms of anesthesia the choice of the anesthetic used and the provider are important.  The surgeon’s skills and the procedures also influence the postoperative picture.  Another factor to consider is the type of care a patient may be given especially if they do have a complication.  Recently studies show that local quality-improvement efforts yield significant improvement in post surgical outcomes.  The picture as you can see is complicated.

Whatever the picture, it appears to be improving with time.  For example, in 1961 a study published by Dripps et al demonstrated that one in every 852 cases suffered a mortality.  That number is very worrisome for anyone in 1961 undergoing surgery.  Fortunately by 1987 the mortality had improved significantly to 1 in 185,056 cases.  This a much more appealing risk and less tinged by gloom.  These improvements are due to the work of creative and dedicated anesthesiologists and surgeons over the last 40 years.

Nausea and Vomiting

A Common Issue

A common problem faced after anesthesia is the presence of postoperative nausea and vomiting (PONV). In the early days of anesthesia, this problem was prevalent and expected from most anesthetics. In our modern era, we have come to expect a better anesthetic experience and expect few of our patients to have to endure this.

Learn more about vomiting

Corneal Abrasions After Surgery

Injury of the Eye

One common complication of surgery noted postoperatively is a corneal abrasion. This is a superficial injury to the surface of the eye which happens during surgery. Many believe It happens if the eye is not completely closed while asleep and is then left exposed. Recently providers have noted the use of an oxygen face mask and surgery occurring with the patient laying on their side that increases the risk.

Neuropathy After Surgery

There is a bothersome little problem many patients have never considered as they undergo a surgical procedure and that is the possibility of developing a nerve injury due to the positioning in the operating room. We call these injuries, neuropathies. What this usually means is that an exposed nerve has been compressed and is usually only temporarily injured.

Aspiration Pneumonia After Surgery

A Feared Complication

One of the most feared complications related to surgery and anesthesia is aspiration pneumonia. This is a less common occurrence today than it was years ago thanks to the many precautions made by anesthesia providers. This condition is brought on by aspirating gastric juices or food particles into the respiratory tract.

Dementia and Confusion

As you get older your brain is more vulnerable to anesthesia. It is more likely you might suffer from at least two conditions that affect your mental functions.

Post-op Delirium

The first is Postoperative Delirium which tends to be a temporary condition that may not develop until a few days after surgery.

Malignant Hyperthermia in Anesthesia

Malignant Hyperthermia as a Killer

In the early years of modern anesthesia, a rare but deadly condition was identified resulting in a severe rise in temperature, pulse rate and blood pressure. These patients also developed a profound muscular rigidity, renal failure, and death. This was, fortunately, a very rare circumstance occurring once in 10,000 to one in 50,000 cases. It became known as Malignant Hyperthermia.

Shock

Shock is one of the most feared complications during and after surgery. This is a situation in which the blood pressure drops to such low levels that the patient’s life or limb is in danger. In most cases it is caused by the underlying condition of the patient such as blood loss, a heart condition or sepsis (blood poisoning). Sometimes medications can also be a cause.

Death During or After Surgery

A Common Occurrence

No one likes to consider this as a possibility. In the good “old” days of early surgery and anesthesia, this was a real possibility. The chance of experiencing death was a 1 in 10,000 among healthy patients whereas in a sicker population was much higher. The major reason for this were the multiple unknowns of anesthesia and surgery.

Muscular Disease

Muscular diseases have been known to cause a variety of problems during and after anesthesia. The complications of anesthesia in patients with known muscular diseases can be divided into two groups.