Side effects and risks of anesthesia
Complications and side effects of anesthesia
Anesthesia and general anesthesia are very safe procedures against the background of modern technology. Despite the fact that there is massive interference in the normal functioning of the organism, side effects of anesthesia or even complications are rare.
Read more on the topic: Fear of anesthesia / general anesthesia
- A side effect after general anesthesia is often nausea and vomiting, the so-called PONV (postoperative nausea and vomiting). For patients prone to PONV, effective drug prophylaxis can be applied during the operation
- Allergic reactions to drugs used or their ingredients
- Damage caused by intubation: Tooth damage (especially in previously damaged teeth); Hoarseness from irritation on the vocal folds
- Tremors after anesthesia Shivering)
- Transfer of stomach contents into the lungs (so-called. aspiration). The risk of these dreaded side effects of anesthesia can be significantly reduced by suitable storage during induction and faster-acting anesthetic drugs.
Read more on the subject at: Types of anesthesia - which are there? or stages of anesthesia
Among the most dangerous Side effects of anesthesia belongs to the Malignant hyperthermia. With a genetic predisposition, frequently used anesthetics lead to a disease that is definitely one intensive care therapy requirement. The focus here is on stabilizing the Cardiovascular system. The frequency is estimated at 1 in 250,000 to 500,000 anesthesia.
Often the idea prepares during the surgery waking up worries the patient very much. The frequency of such intraoperative wakefulness (Awareness) is different depending on the subject and varies in the literature with regard to the frequency.
This is mainly due to the fact that the patient does not necessarily remember the state of wakefulness (so-called Recall). However, to take the worry out of such a state of wakefulness: The frequency of wakefulness with a memory of this state is given as 0.02% to 2%. An even smaller percentage of these memories are emotionally charged. The number of emotionally charged memories that are primarily negative in character is even lower.
In summary, the side effects caused by the anesthesia can be rated as minor. Nevertheless, it should always be considered whether an anesthetic should be avoided.
Duration of side effects
How long the side effects last after anesthesia varies from patient to patient. While some do not complain of side effects at all, others struggle with nausea and vomiting. In addition, the duration of the side effects is related to the duration of the operation. The longer the anesthetic lasts, the longer and more pronounced side effects can occur.
The most common side effects after surgery are Nausea and vomiting. These occur after about 30% of general anesthesia. As special medication, the so-called Antiemetics, against which nausea can be given, it usually goes away quite quickly. If left untreated, it takes about 2-3 hours on.
Maybe that is Voice a little rough after surgery and the throat hurts. This comes from the ventilation tube that is placed in the windpipe during the operation. The feeling can persist for up to a few days after anesthesia stay.
The dazed feelingThe length of time that most patients have after general anesthesia varies. That's why it is It is important not to actively participate in road traffic 24 hours after the operation and to spare yourself.
Typical side effects of anesthesia
Nausea after anesthesia
Nausea, along with vomiting, is one of the most common side effects of anesthesia. In technical terms, one speaks of postoperative nausea and vomiting (PONV "postoperative nausea and vomiting").
Both nausea and vomiting are protective reflexes of the body that are supposed to protect against toxic substances from entering the body. The body recognizes the drugs that are used for anesthesia as harmful to the body and tries to eliminate them.
With general anesthesia, the risk of nausea and vomiting after the operation is around 30%. But even with local anesthesia, it can lead to nausea. The risk here is only around 10%. Therefore, depending on the type of operation, it is possible to reduce the risk of postoperative nausea with local anesthesia or anesthesia close to the spinal cord.
The risk can increase significantly due to various factors. These risk groups include women, non-smokers, those suffering from motion sickness and patients with a long operation and therefore also anesthesia. In addition, the nausea depends on the choice of anesthetic drug (Anesthetic). If inhalation anesthetics are used during anesthesia, nausea is more common afterwards. Many clinics and doctors therefore try to keep the use of gases as low as possible and to resort to other drugs.
As a rule, the nausea will go away on its own after a few hours. However, there are also drugs (Antiemetics), which work against nausea and which can be given after the operation. If there is an increased risk, these drugs can also be given prophylactically during the operation.
Nausea and vomiting after an operation is not uncommon, but in most cases it is harmless and of short duration. However, complications can rarely occur and the respiratory tract may be disturbed with a lack of oxygen or the esophagus may tear.
Read more on the subject at: Vomiting after anesthesia
Confusion after anesthesia
The anesthesia particularly affects the processes in the human brain. Because of its complexity, confusion after anesthesia is a not uncommon side effect. Immediately after waking up, confusion after every anesthetic is initially completely normal. Even if the patient is already awake and showing initial reactions, a certain amount of anesthetic is still in the body and affects consciousness.
This leads to disorientation and confusion in the waking up phase. After minutes or half an hour, the condition returns to normal. In addition to this confusion that occurs during the awakening phase, there are also states in which consciousness is restricted more clearly and for longer. Even if this is more likely to be the case in older patients, young patients can also be affected. If increasing confusion occurs hours or a few days after the anesthesia and lasts longer, the doctor speaks of postoperative delirium. It manifests itself in difficulties to orientate oneself in time or place. The person concerned does not know where he is or what day it is today. Likewise, the memory can be impaired to different degrees, this ranges from short memory gaps to not recognizing relatives. The alertness and activity of those suffering from this form of confusion are divided into two forms, a hypoactive and a hyperactive form.
While the hypoactive form is more common and presents itself as being withdrawn and difficult to respond, the rare hyperactive form is characterized by pronounced restlessness, which can even lead to bed escape. These side effects go away a few days after they first appear. Friends and relatives can use familiar environments and stories to speed healing.
In individual cases, similar symptoms do not appear immediately after anesthesia, but only after weeks and are more pronounced. This side effect of anesthesia is called postoperative cognitive dysfunction. It goes hand in hand with the greatest confusion and impairment of almost all cognitive functions, such as Concentration, memory and attention. The risk of this disorder increases with the extent and duration of the operation and thus the anesthetic. However, this side effect is also reversible and usually goes away on its own.
Overall, it can be said that confusion in various forms is a common side effect of anesthesia, but it almost never requires special treatment and spontaneously returns to normal within days.
Find out all about the topic here: postoperative delirium.
Headache after anesthesia
a headache are a possible side effect during anesthesia. Typically they occur at the near the spinal cord, regional procedures like one Epidural anesthesia but can also occur during general anesthesia.
Older patients in particular suffer from headaches after anesthesia, which is exacerbated by possible concomitant diseases. Long-term procedures and complicated operations also increase the risk of headaches.
Some remedies like that often used Propofol can cause headaches as a possible side effect in the waking up phase, but these are not long-lasting and go away on their own.
The influence of drugs is only one possible cause. Headaches are usually not known to be a common side effect of the drugs used, but rather a cause of processes during anesthesia. Of course, interventions on the head always carry the risk of this side effect, which cannot be prevented.
For some operations, the Head stored low so that the head is the lowest point of the body during the entire period of anesthesia. The blood follows gravity, which can cause a headache when you wake up.
Another cause of headaches after anesthesia are unbalanced balances in the body. For example a slight loss of blood or water during the procedure, which has not yet been compensated for, can cause a headache. Help here quickly Infusions. Eventually, with the liquid too Electrolytes, say salts like sodium and potassium, fed back into the body if these concentrations are no longer correct. If the headache does not go away on its own after a certain time, there is the possibility of using additional painkillers such as Ibuprofen suppress the pain.
A risk group for headaches are patients with migraine. These often suffer from this side effect, but can also be treated accordingly.
In summary, headaches can occur as a side effect after anesthesia, especially with the appropriate intervention - low head position, long surgery - but overall they represent a rare side effect and are usually easy to treat. Often they join regional anesthetic procedures on.
Diarrhea after anesthesia
Mothers of young children in particular often come to the clinic because their child is under anesthesia after an operation Diarrhea suffers.
Talking to a doctor can rarely find out the actual cause. But what can that be?
The first thing to say is that diarrhea not to the usual side effects anesthesia counts. The drugs used do not work Intestines and so cannot cause diarrhea.
In fact, post-operative side effects are more common nausea and Vomit, such as nocturnal restlessness and rarely too Cognitive disorders.
However, all of these symptoms usually go away without a trace over time and do not leave any long-term effects. Nevertheless, many patients are now asking themselves: Where does my diarrhea come from?
Often times, surgery is one difficult stressful situation for many patients. The fear of pain, the long recovery time and other unpleasant side effects of an operation are perceived very differently by patients.
In particular, fearful people now tend to increased stresswhich ultimately turns into a nervous bowels can manifest and thus cause diarrhea.
Especially children who do not really understand operations and who cannot imagine anesthesia are often after an operation scared and overwhelmed. Because of this, they suffer more often from post-operative diarrhea.
In rare cases there is one intolerance possible cause compared to the drugs used.
But how should a mother deal with the situation?
Since the diarrhea usually has no medical cause, it is often unnecessary to see a doctor.
However, if the operation took place on the bowel and the diarrhea lasts for several days and is associated with pain, a doctor should always be consulted.
Possible cause could be a Inflammation in the intestines be what by the operation but not by the anesthesia has been caused.
Otherwise, patients should save and Keep bed rest. The is still particularly important Compensate for fluid loss.
Because the body already has diarrhea up to 5 liters The sufferer should definitely lose fluids much drinking.
Mild teas such as chamomile tea, but also cola or simply water, are suitable.
Dry foods such as pretzel sticks or rusks are suitable as solid food.
Hair loss after anesthesia
With the Hair loss it is similar to the diarrhea after anesthesia. Because here, too, the drugs of the anesthesia are not to blame.
The anesthesia itself is a great stress on the body . Additionally with the mental component results in a strong stressful situation for the patient.
As is well known, prolonged stress can lead to mild hair loss. Therefore, in rare cases, hair loss occurs in patients, but this is not due to the medication but to the stressful physical strain.
It is also discussed whether a Relaxation of the cells in the hair follicle may be a trigger for hair loss.
The anesthesia puts the body into a kind of deep sleep in which all muscles are relaxed. In addition, the metabolism is shut down and the cells work less. If this also applies to cells in the hair roots, which are responsible for anchoring the hair shaft in the scalp, they can no longer fix the hair strong enough and it falls out.
However, it should be emphasized that this is only an unproven theory is that one shouldn't just blindly believe.
Restlessness after anesthesia
In rare cases, patients complain after one general anesthetic over Restlessness and insomnia. This can be a real burden as patients should rest after anesthesia.
After all, anesthesia puts a lot of stress on the whole body. But where does the unrest come from?
It is safe to say that it is not caused by the drugs that are used in general anesthesia. These actually have the opposite effect: they drive down the metabolism and care for the patient fatigue.
So is the unrest just imagination? Yes and no. Everyone experiences anesthesia differently. Since it is often associated with major surgery, many patients are afraid. In addition, there is that Feeling of defenselessness during a deep sleep.
All of this can be very stressful. who stress has will restless. Thus, people with thin nerves are more likely to suffer from said restlessness.
If so, the doctor may advise light sedative to help patients relax after anesthesia.
Often also helps deflection, for example by reading or watching TV, or also mental support by relatives and friends.
Forgetfulness after anesthesia
forgetfulness, confusion, Disorientation and cognitive dysfunction can be seen in rare cases in patients after anesthesia.
These symptoms occur particularly frequently in older men, some of whom are already cognitively impaired (e.g. due to dementia) or other diseases such as a high blood pressure or one diabetes to have.
General anesthesia is suspected of degenerative brain diseases such as Alzheimer to aggravate.
It is noticeable that the forgetfulness occurs predominantly after unplanned operations. You can do this Broken bones from falls or major emergency operations on the heart.
The real cause of these symptoms is not yet fully understood. Are under suspicion small sores in the brainthat occur during the operation and damage it.
How does the doctor recognize forgetfulness after anesthesia?
Quite simply by asking. For example, the patient should after the surgery know his name, the date as well as the place where it is located.
Furthermore, he should recognize his loved ones and be able to answer specific questions.
Often patients are after an anesthetic foggy and unable to formulate clear sentences. In most cases, however, these symptoms have already subsided a few hours after the operation.
Side effects on the eye
Real damage to the eye after one general anesthetic occur and can be directly associated with it are unknown.
Often the patient is after an operation briefly black before eyesbut this is not due to damage to the eye.
This visual loss is on one Drop in blood pressure traced back. This is a normal consequence of anesthesia, as it puts a great strain on the entire human organism.
To adequate hydration and adequate bed rest the problem should go away on its own.
Another symptom that may be caused by anesthesia is the so-called Eye migraines.
she is painless and characterized by bright flashes in the field of viewthat appear spontaneously and just as spontaneously disappear again.
An eye migraine is on one temporary insufficient blood supply to the brain in the visual cortex traced back. The cause can be, for example Vascular spasm be.
However, an actual connection with an operation or anesthesia has not been proven.
Side effects in children
Since the procedures of anesthesia are now well understood in children and there is a lot of experience, anesthesia can be safely used in children.
Of course, there is also the potential for side effects in this particular group of patients. First of all, like everyone else, children can suffer from side effects typical of this procedure after anesthesia.
This includes above all the Postoperative Nausea Associated with Vomiting (PONV). This not uncommon side effect is observed more frequently in children than in adults, but is usually self-limiting a few hours after anesthesia. In severe cases, there are several effective anti-nausea agents available.
Another side effect, that postoperative tremors after anesthesia, is also described more often in children, as they are more sensitive to the cold due to their physical conditions. Then help here Cover and if necessary warm infusions. Immediately after waking up from anesthesia, the children are often confused and do not know where they are, which in comparison to adult patients can cause severe fear or even panic, which is why the presence of the parents during the waking up phase is not unimportant. The children can scream and cry loudly. However, this is a reaction to the remedies still working in the body and the confusion, it should not be misinterpreted as pain as adequate pain medication has been given.
A popular anesthetic is gas Sevoflurane. Compared to other inhalation anesthetics, this has the advantage that it is less irritating to the airways and less likely to cause irritation after anesthesia to cough, hoarseness and also Pain reduced. Therefore it is often used for anesthesia in children. However, there may be a specific side effect here Agitation, come. That is, the children very active postoperatively and sometimes behave like rushed. In more pronounced cases, they can hardly be immobilized and wander aimlessly. However, this is one of the rare side effects of anesthesia in children and goes away on its own.
What must also not be ignored is the possible Traumatization of the child through the procedure. Therefore, it is important in advance to make the anesthesia processes at least partially understandable to the child, together with the doctor and the parents, and overall for one create a positive atmosphere before and after anesthesia.
Side effects in the elderly
Elderly people form a special group of patients, as older patients often experience several comorbidities and they may react differently to medical interventions than younger patients. In the context of anesthesia, side effects are more likely to occur.
In older patients, cognitive side effects, i.e. side effects related to consciousness and brain function, play a role. Postoperative delirium is a relatively common side effect of anesthesia after surgery. Various functions of the brain such as the memory, the orientation in space or time up to the general consciousness be restricted. This side effect occurs in older patients a few hours to days after anesthesia, with a frequency of approx. 5-15%, which can increase to up to 50% in very complex and long operations. Postoperative cognitive dysfunction must be distinguished from postoperative delirium. The difference is that this side effect only occurs days or weeks after the anesthetic. The described disorders of the ability to concentrate and the memory are similar.
More detailed information on this topic can be found under the article: Anesthesia in the elderly
These side effects, which are more common in older patients, are in most cases not permanent and do not cause long-term damage. According to recent studies, however, long-term damage can occur in individual cases. It is currently being discussed whether anesthesia is a dementia can accelerate or trigger. The mechanism behind this is not yet understood. Overall, however, these are isolated reports that the majority of elderly people operated under anesthesia suffer having only slight or none of the side effects described above. In addition to the cognitive, consciousness and thinking side effects, generally known side effects of anesthesia are of course also possible in older patients.
This typically includes that PONV (postoperative nausa and vomiting)what is going through nausea and Vomit noticeable after anesthesia. This can be extremely uncomfortable, but usually only lasts a few hours after the operation and can usually be treated well with medication.
It is also known as a side effect of anesthesia postoperative tremors. Probably caused by temporary hypothermia during the procedure, this is also usually a harmless side effect.
In addition, due to the reduced resistance compared to younger people and possible secondary diseases, the recovery time after anesthesia can be longer.