المصدر: common side effects after anesthesia في منتدى : كتب طبية Common side effects after anesthesia Common side effects and minor risks associated with anesthesia Most side effects of general anesthesia are minor in people who are otherwise healthy and they can be easily managed by your anesthesia care team. Some of the most common ones are discussed below. 1. Nausea and vomiting after surgery (Also called postoperative nausea and vomiting) occurs in the first 24 hours after your surgery. It affects 20-30% of patients. Nearly half of all patients who do not have PONV in the hospital, experience nausea and/or vomiting in the first few days after discharge. Who is at risk? 1-being female 2- having a history of motion sickness 3-history of PONV after a previous surgery. 4- Some anesthetic drugs and painkillers, the morphine-like painkillers (called opioids in medical terms) and laughing gas (called nitrous oxide in medical terms). 5- Surgery on the ear or intestines and laparoscopic surgery. Can it be prevented and/or treated? 1-It is important to inform your anesthetist that you had this problem in the past. Your anesthetist can choose a different way of giving your anesthetic 2. When the choice is available, patients should be advised that the risk of PONV decreases when regional rather than general anaesthesia is administered . 3. The perioperative use of opioids should be minimized. Surgeons should evaluate the risks/benefits of opioid administration to decrease the risk of PONV . 4. Prophylactic antiemetics should be administered to patients with moderate or high risk of developing PONV. ( metoclopramide 10 mg ) 5. In patients with a high risk of developing PONV, combination antiemetic therapy should be considered. (metoclopramide &ondansetron) 6. When prophylaxis with one drug has failed, a repeat dose of this drug should not be initiated as a rescue therapy; instead, a drug from a different class of antiemetic drugs should be administered. 7. As patients who undergo surgery in surgical daycare units may have PONV after they are discharged, they should be given instructions for its management. 8. Patients at high risk of developing PDNV should be provided with rescue treatment. 2. Sore throat Sore throat and hoarseness in the first hours to days after anesthesia occurs in up to 40% of patients. Who is at risk?1- Being female 2- younger than 50 years old 3- having a general anesthetic lasting more than 3 hours. Can it be prevented and/or treated? 1-Having a regional anesthetic will completely prevent this problem. 2-However, if you need a general anesthetic, your anesthetist may chose a smaller size for the device used to help you breath during surgery. 3- Some drugs have also been proven to be beneficial, such as a freezing medication or an anti-inflammatory medication. 4-In addition, the use of some over the counter substances such as Tantum or Strepsils can help alleviate acute sore throat pain. 3. Teeth damage 1:2000-cases. The most frequently injured teeth are the upper front ones (the upper incisors) Who is at risk?Those with poor dental health and where the anesthetist have had difficulty to ‘get the breathing tube down’ (called a ‘difficult intubation). Can it be prevented?1-Although the anesthetists are always very careful, prevention of dental damage is not always possible. 2-Several devices have been used such as mouth-guards and bite-blocks but provide no guarantee. 4. Shivering/Chills 25-50% of patients. Who is at risk?1-Cooling down is the most common cause. ( cold IV fluids , cold OR temperature…) 2-Other causes including include pain, fever and stress after surgery. 3- It seems to be more common in males and after longer surgeries, but it is quite rare in elderly patients. Can it be prevented and/or treated?1-While we try to reduce the drop in body temperature ( by using warm fluids, not reducing OR temperature than 22,…) 2-There are also a few drugs that can be used either to prevent and/or to treat post-operative shivering as mepredine (25-30 mg).