Possible causes of death during anesthesia

This is an automatically translated article.

The article is professionally consulted by Specialist Doctor I Tran Thi Ngat - Department of General Surgery - Vinmec Danang International General Hospital.

1. Control the airway

Control of the airway is a key factor in the anaesthesia. If the patient is deprived of oxygen, it can lead to many other dangerous complications.
Lack of oxygen after about 4-6 minutes, the patient will have brain death, a longer time may have cardiac arrest. The airway must always be secured, with general anesthesia, an endotracheal tube is used to ensure the patient's breathing.
If the endotracheal tube is placed in the wrong position into the esophagus, oxygen will not be able to get into the lungs and after only a short time, the patient will become cyanotic and possibly have a cardiac arrest. However, now that many tools and machines are used, the risk of wrong intubation has been greatly reduced.
Failure to assess the patient's abnormal anatomy may also make intubation difficult or possibly impossible. Since then, trying to intubate many times will also injure the airways, hindering breathing. In this situation, if the tracheostomy is not promptly opened, the patient may die from lack of oxygen.
There are many new tools available to assist in such emergencies. These include tools such as fiberoptic bronchoscopes, LMA masks. Devices that help open the upper airway and allow the patient to breathe temporarily.
Cases of choking or inhaling food from the stomach are sometimes the cause of death for patients. Pregnant or severely obese patients or trauma victims and patients with intestinal obstruction have a full stomach. Using anesthetic or paralyzing drugs and gentle pressure on the neck will prevent food from backing up from the stomach to the esophagus, thereby reducing aspiration to a minimum.

2. Residues of muscle relaxants cause respiratory muscle paralysis

This is a phenomenon known as muscle relaxation. During anesthesia, to facilitate the surgical anesthetic process, the patient is given a relaxant. After surgery, the amount of muscle relaxant can be left over, causing muscle paralysis, making the patient unable to breathe on their own, leading to lack of oxygen.

3. Use strong tranquilizers

The use of strong sedatives is also a very common cause of death. Strong sedatives work to make the patient feel more comfortable when having to perform "minor" surgery. Not only has a sedative effect, this drug can also cause respiratory depression, causing the patient to stop breathing and be deprived of oxygen.

4. Method of “Awakening Pain Relief”

Awakening analgesia is pain relief but only induces mental relaxation without causing the patient to lose consciousness. However, the lines between the two conditions are very thin, and the safe dose for each patient is different.

5. Pneumothorax

The ventilator is malfunctioning, resulting in an inadequate supply of breathing air to the patient.
Increased pressure in the lungs can tear the lung, which can increase outside the lung and press on the blood vessel that carries blood back to the heart and reduce cardiac output. The patient can die if the pneumothorax is not detected and a drainage tube is placed in time.
Pneumothorax is not an easy case to diagnose. Traumatic patients are at very high risk of pneumothorax. Other causes may be a puncture of the pleura when the needle is inserted into the major blood vessels.

6. Circulatory System

Patients may experience blood loss during surgery and the anesthesiologist must fully replace the lost blood and fluids. It is important to anticipate a large loss of blood and fluid in order to plan and place an intravenous line.
An overdose of volatile anesthetics and intravenous anesthetics can cause the heart to stop beating. Patients have slightly different responses to anesthetics.

7. Allergic reactions

Allergic reactions to drugs are often life-threatening. However, volatile anesthetics are less likely to cause this reaction. Allergens can cause low blood pressure, wheezing and lead to inability to breathe on their own.
Other drugs used in combination such as muscle relaxants, intravenous anesthetics, antibiotics can cause hypersensitivity reactions.
Latex can also cause life-threatening allergic reactions.

8. Malignant Hyperthermia (MH)

Patients develop high fever, increased heart rate, muscle stiffness and possibly death under anesthesia. This problem is hereditary, resulting from defects in skeletal muscle metabolism when exposed to certain general anesthetics or paralytic drugs.

9. Increase Potassium After Using Succinylcholine

Increased potassium has the potential to be fatal when succinylcholine is administered to victims of burns, trauma, or spinal cord injury. What is less well known is that this phenomenon can occur weeks after trauma in immobile patients.

10. Local anesthetics

If local anesthetics are injected into the bloodstream in large doses, the patient will have convulsions and cardiac arrest. Anesthesiologists need to understand this issue very well to be able to make a quick and emergency diagnosis to avoid death.

11. Machine problems

The user must comply with the checklist before putting into operation the machine. The inspection will help detect most of the mechanical problems to avoid consequences for the patient.

12. Human factor

Modern anesthesia involves a lot more than just medication. Anesthesiologists need to have knowledge and to anticipate and respond sensitively to changes that may occur during surgery. Anesthesiologists and anesthesiologists must always be thoroughly trained before practicing.
Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading medical doctors, modern equipment and technology, but also stands out for its examination and consultation services. comprehensive and professional medical consultation and treatment; civilized, polite, safe and sterile medical examination and treatment space.
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