Post operative Complications & Their Prevention

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Types of post-operative complications

Post- operative complications generally fall in one or more of the three broad categories

1. Anesthesia related complications

2. Complications common to any procedure

3. Complications common to specific procedure

Depending on the severity of the complications they can again be broadly categorized as Major or Minor.

Minor Complications -Dryness of the mouth and throat, sore throat, drowsiness, shivering, vomiting, dizziness, and giddiness are common side effects of the medicines used during anesthesia. They are self-limiting and do not persist beyond an hour or two.

Fatigue, feeling weak, headache are also common and could be attributed to the fasting that is often required before and after a surgery. Under normal circumstances these symptoms vanish in a day or two.

Some people also experience bloated feeling, constipation and urine retention following an operation and these resolve spontaneously.

Fever can occur as a reaction to the intravenous fluid transfused during an operation.

Major Complications - These complications can be serious and sometimes even life-threatening. They prolong the recovery period and stay in the hospital. The complications may happen during surgery or in the post-operative period. Some of these include -

1.Pulmonary thromboembolism - Clots formed in the deep veins of the legs or thigh can get detached from the leg veins and travel to the lungs and get stuck in the major artery supplying the lungs causing a fatal collapse. These clots are formed in the leg veins when a patient is in prolonged immobilization following a surgery.

2. Aspiration of stomach contents into the lung - This can happen during the initiation of anesthesia if a patient has eaten a meal before the surgery. The food and acidic contents of the stomach can be inhaled into the lungs setting up a severe near-fatal pneumonia of the lung.

3. Anaphylaxis - is a severe allergic reaction to either the anesthetic agents or antibiotics or certain substances used during the operation (e.g-cement used during a joint replacement surgery)

4. Cardiac arrest - is possible as an end result of any of the above events. Prompt cardio-pulmonary resuscitation can help revive the person.

Other possible complications may occur and be related to pre-existing medical illness

A person who suffers from ischemic heart disease, diabetes, high blood pressure, asthma, kidney disease, liver disease, epilepsy, psychosis can expect an exacerbation of these problems in the post-operative period.

Therefore such a patient may develop a heart attack, stroke, high blood sugar, severe asthma, liver or kidney failure following the surgery. The likelihood of these eventualities is more if any of the above mentioned conditions are not under control and the patient is not under regular medication.

A thorough pre-operative evaluation of the risk factors is essential when dealing with patients who have these co-morbid condition. Diabetes and hypertension is not uncommon in the middle and older age group patients. Control of sugar and cardiac evaluation prior to surgery is mandatory in such situations.


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