Assignment on Use of anaesthesia techniques on patients and complications in surgery

Abstract on Use of anaesthesia techniques on patients and complications in surgery

Purpose: This aim of this study is use the different techniques of anesthesia on the patients and after that complication of the surgery is explained.

Background: The Ambulatory anesthesia which permits the quick recovery from the anesthesia that also leading the rapid as well as discharge of the resumptions for the daily activities. By the development of the minimally invasive surgery techniques as well as the short acting of anesthesia by the use of Ambulatory surgery. For the safe as well as successful Ambulatory anesthesia, the anesthesiologist suppose the different factors relating to patients Appropriate anesthetic techniques  and surgical should be used to minimize postoperative complications, especially postoperative pain, nausea, and vomiting..

Methods:  The preoperative complications, by the use of the carotid artery shunt, where the duration of the operative is procedure as well as postoperative hospital cure compared by the 584 concretive patients which undergoing 679 carotid. The carotid endarterectomies with use of either general anesthesia or cervical block regional anesthesia  Symptomatic carotid artery disease was an indication for surgery in  patients receiving general anesthetics, whereas  patients treated with a cervical block anesthetic had a symptomatic carotid artery stenos is

Results: The perioperative stroke rate plus stroke-death rate for the entire series was  as well as    carotid artery shunt was used in 61 (19.2%) patients receiving a cervical block anesthetic and  patients treated with a general anesthetic

Conclusion: It is concluded that a cervical block anesthesia is safer as well as results in a more efficient use of hospital resources than general anesthesia in the treatment of patients undergoing carotid endarterectomy.

Introduction on Use of anaesthesia techniques on patients and complications in surgery

The continuous improvement in the anaesthesia techniques has increased the rate of ambulatory surgery as well as carotid endarterectomy. There are consistent changes in the methods used for anaesthesia, for example in the 1990s the concept of quicker recovery from anaesthesia was introduced that result in rapid discharge from hospital and resumption towards the daily activities (1). Major morbidity and mortality are directly linked with the ambulatory surgery and carotid endarterectomy when it is compared to the inpatient surgeries (2, 3). There are several advantages of ambulatory surgery when it is compared to the inpatient surgeries for instance hospital costs, the lower rate of cancellations, less waiting times, and low risk of nosocomial infection. The selection of anesthesia technique is based on the type of operation, patient age and possible health complications. Due to the appropriate selection of the anesthesia conditions, it is possible to improve the conditions of the patient (10). The effective evaluation for the selection technique can speed up the process and can save the time of patient and surgeon.  For the successful ambulatory surgery, and carotid endarterectomy it is necessary to have the appropriate procedure of carotid endarterectomy and ambulatory anaesthesia. In this way, the primary concern is the ultimate health of the patient and potential side effects (4-6).

The main aim of the present work is to analyze the use of anaesthesia techniques on patients and complications in surgery. This work will discuss all the prospects of patient selection, postoperative management for effective ambulatory anaesthesia and carotid endarterectomy, and methods of anaesthesia. 

Techniques of  Use of anaesthesia techniques on patients and complications in surgery

There are different techniques of anaesthesia and choice of anaesthetic method is based on the patient factors, operation, possible complications, and anticipated degree of pain. Different anaesthetic techniques include general, spinal, epidural, regional, caudal, total intravenous, inhalation, nerve blocks, and hypotensive (8). The description of these techniques is listed below,

1.      Central neuraxial blocks include caudal, spinal and epidural anaesthesia that is regional anaesthesia. It is performed in the surgical procedure and provides excellent pain control.

2.      Epidural technique is used for multi model postoperative pain control.

3.      Hypotensive epidural anaesthesia is used to decrease blood loss in hip surgeries.

4.      Caudal anesthesia is used to perform pediatric patient, postoperative analgesia, and surgery.

5.      Regional anesthesia provides excellent pain control, decrease side effect, increase pulmonary function, reduce hospital stay, and prevent chronic pain.

6.      Total intravenous anesthesia (TIVA) is used in surgeries (9).

Data collection and Method on Use of anaesthesia techniques on patients and complications in surgery

The data used in the analysis is collected from the Al Falluga teaching Hospital to analyze the importance and complications of using anaesthesia in surgical operations.  The data collected from Al Falluga teaching Hospital consist of the process used by the surgeon for the patient selection. The selection of patient depends on surgical considerations, social consideration, medical consideration, and anesthetic considerations. Details of the selection process are mentioned below, 

Data Collection on Use of anaesthesia techniques on patients and complications in surgery
For this purpose, data is collected from Al Falluja teaching Hospital of Iraq. The selected source of data is a 200-bed general hospital where surgeons are using anesthesia techniques during surgeries (7). The collected data is analyzed, and results are used to determine potential findings regarding the use of anaesthetic techniques in surgeries.

1.      Patient selection

Approximately all the patients are eligible for the ambulatory surgery and carotid endarterectomy but there are specific conditions that surgeons of Al Falluga teaching Hospital consider before starting the surgery. The appropriate patient selection is necessary due to increased incidents of comorbidities and complexity of surgical procedures (11). The preoperative assessment defines improved perioperative results. The data collected for the selection of patient include the anesthetic factors, surgical, medical and social factors.

Results on Use of anaesthesia techniques on patients and complications in surgery

On the basis of data collected from Al Falluga teaching Hospital the results are extracted for the ambulatory surgery and how anesthesia can be used in the surgery. There is no clear guideline for the selection of the optimal anesthesia (18, 19). The report analyzed controversies in anesthetic methods and complications in the carotid endarterectomy surgery. The complications in the surgery are the issues in the ambulatory surgery and carotid endarterectomy.  

Controversies in anesthetic methods

Perioperative neurologic events occurred after 35 (5.15%) operations (Table 1). Nineteen (2.8%) were temporary neurologic deficits or perioperative seizures, and 16 were strokes for a perioperative stroke rate of 2.4%. Ten (2.8%) of the operations performed with the patient receiving general anesthetic were complicated by stroke, whereas six (1.9%) carotid endarterectomies performed with the

Table 1: Transient ischemic artack; MI, myocardial infarction

Total Intravenous anesthesia versus inhalation anesthesia

The advantages of TIVA versus inhalation anesthesia have some conditions that are rapid recovery, behavioural disturbances and agitation. This helps in avoiding environmental pollution and malignant hyperthermia (20-23).

General anesthesia versus regional anesthesia

The selected data show large scale studies and regional anesthesia has a lower morbidity rate as compared to the general anesthesia. The generalized clinical studies are used in the reports to measure the drawbacks of each method. There is no accurate data provided for the pain control and treatment principles (24, 25). The use of non-steroidal anti-inflammatory drugs (NSAIDs) is measured as less ineffective for controlling the use of narcotic. Use of anesthesia reduces the risk of vomiting, nausea, fluid therapy, minimization of analgesics of narcotics and effective treatment (21, 26).

Complications in surgery on Use of anaesthesia techniques on patients and complications in surgery

In order to reduce the possibility of complications in surgery surgeons must discuss the use of anesthesia with the anesthetist. The important complications of general anesthesia include pain, nausea, vomiting, damage to teeth, sore throat, respiratory depression, anaphylaxis to anesthetic agents, cardiovascular collapse, hypoxic brain damage, embolism, headache, aspiration pneumonitis, iatrogenic and hypothermia (27). 

Anaphylaxis: Anaphylaxis can occur due to anesthetic agent and the reactions include rash, hypotension, bronchospasm, vomiting, urticaria, and angioedema (28).

Aspiration pneumonitis: The complication occurs in case of the unprotected airway and if the patient vomit there is a possibility to come back to the lungs. The pH of gastric content can damage the lungs.

Peripheral nerve damage: This occurs due to anesthesia and nerve compression. The common cause is exaggerated positioning and a long period of time. The surgeons must be aware of potential complications such as injury of nerves. The extreme postures during surgery must be considered (29).

Embolism: The potentially fatal issue in anesthetic complications is embolism that occurs during pelvic operations and neurosurgical procedures. The issue becomes severe in pre-operative and low molecular weight heparin (LMWH) and thromboembolic deterrents (TEDS) (30).

Conclusion on Use of anaesthesia techniques on patients and complications in surgery

The data used in the analysis were collected from Al Falluga teaching Hospital. The report concluded that medical technology has been using anesthetic techniques for the ambulatory surgery. The fast and short act of anesthetic techniques under analysis. There are some complications and issues in using anesthetic techniques that surgeons must consider in the complex medical procedures. The selection of anesthesia techniques is based on the conditions of patients, disease, surgery requirements, and family history. The common complications are postoperative complications such as vomiting, pain and nausea. It is important to have better recovery for the optimization of patient status.

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