Introduction to Anaesthesia Complications
Designed as a quick‑reference guide for students, trainees, and clinicians.
1. Why Study Anaesthesia Complications?
| Reason |
Clinical Impact |
| Patient safety |
Reduces morbidity and mortality |
| Legal & ethical responsibility |
Informs consent and documentation |
| Quality improvement |
Guides protocol development and monitoring |
| Team communication |
Enhances intra‑operative vigilance |
2. Classification of Complications
| Category |
Timing |
Typical Examples |
| Pre‑induction |
Before drug administration |
Difficult airway, severe hypovolemia, uncontrolled hypertension |
| Induction |
During loss of consciousness |
Hypotension, bronchospasm, aspiration, malignant hyperthermia |
| Maintenance |
Throughout surgery |
Awareness, drug toxicity, arrhythmias, temperature dysregulation |
| Emergence |
Extubation & immediate recovery |
Laryngospasm, nausea/vomiting, delirium, residual neuromuscular blockade |
| Post‑operative (PACU/ward) |
Hours to days after surgery |
Respiratory depression, wound infection, cardiovascular events, postoperative cognitive dysfunction (POCD) |
3. Common System‑Specific Complications
3.1 Cardiovascular
| Complication |
Typical Triggers |
Early Signs |
Immediate Management |
| Hypotension |
Induction agents, neuraxial block, hypovolemia |
↓ MAP, tachycardia, pallor |
Fluid bolus, vasopressors (phenylephrine, ephedrine) |
| Hypertension |
Pain, inadequate depth, catecholamine surge |
↑ BP, tachycardia |
Deepen anaesthesia, β‑blocker, vasodilator |
| Arrhythmias |
Electrolyte imbalance, drug toxicity |
Irregular pulse, ECG changes |
Treat underlying cause, anti‑arrhythmics (e.g., lidocaine) |
| Myocardial Ischemia |
Stress, tachycardia, hypotension |
ST changes, chest pain (if awake) |
Optimize oxygen delivery, β‑blocker, nitrates |
3.2 Respiratory
| Complication |
Typical Triggers |
Early Signs |
Immediate Management |
| Airway obstruction |
Difficult mask ventilation, laryngospasm |
Stridor, desaturation |
100 % O₂, jaw thrust, CPAP, succinylcholine if needed |
| Aspiration |
Inadequate fasting, reflux |
Cough, wheeze, ↓ SpO₂ |
Suction, bronchoscopy if required, antibiotics |
| Bronchospasm |
Asthma, irritant gases |
Wheeze, ↑ peak pressure |
β₂‑agonist inhalation, deepen anaesthesia |
| Respiratory depression |
Opioids, residual neuromuscular block |
Hypoventilation, ↑ CO₂ |
Reduce opioid, reverse NM blockade, assist ventilation |
3.3 Neurologic
| Complication |
Typical Triggers |
Early Signs |
Immediate Management |
| Awareness (intra‑operative awareness) |
Light anaesthesia, high tolerance |
Patient recall, movement |
Verify depth (BIS, EEG), adjust agents |
| Seizure |
Local anesthetic toxicity, propofol infusion |
Motor activity, EEG changes |
Stop offending drug, benzodiazepine, correct electrolytes |
| Stroke / TIA |
Hemodynamic instability, |
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