Maintenance of intubation anesthesia
To maintain intubation anesthesia, a narcotic must be administered continuously. Two different principles are available for this. One can continue to inject intravenous drugs via a perfusor (e.g. propofol, thiopental, etomidate, barbiturates) or switch to inhaled narcotics such as desflurane or sevoflurane.
In addition, painkillers must be re-injected for longer or particularly painful operations. Various groups of active substances are available (opiates, non-steroidal anti-inflammatory drugs). During general anesthesia, blood pressure or heart rate fluctuations can occur, and medication may be necessary to counteract these. In addition, fluid is always administered by infusion.
Anaesthetic drainage
The end of the anaesthesia and awakening of the patient is called discharge. Towards the end of the operation the supply of the anaesthetic is stopped, depending on the anaesthetic it takes 5-15 minutes until the patient regains consciousness, breathes independently, opens his eyes and reacts to speech. It is important to make sure that the muscle relaxant has been completely broken down by the body, otherwise the patient will not be able to breathe independently.
If the patient is able to take deep breaths on his own, the breathing tube can be removed. The stomach should be suctioned out beforehand, because stomach contents can be swallowed even when the patient wakes up. After the drainage the patient is brought to the recovery room and monitored for at least one hour.
These risks exist
There are some risks associated with any general anesthesia, such as allergic reactions to administered medications up to anaphylactic shock. Circulatory disorders in the form of low or high blood pressure or heart rate. In addition, respiratory problems may occur, especially patients with lung diseases (asthma, COPD) and smokers are particularly at risk of suffering from bronchospasm (narrowing/contraction of the airways).
Special risks of intubation are tooth damage, which can be caused by the rigid spatula, soft tissue injuries in the mouth and throat area with bleeding and swelling. When the tube is inserted through the glottis into the trachea, the vocal cords can be irritated or damaged. After intubation, many patients complain of slight sore throat and hoarseness, but these disappear on their own after a few hours.
In rare severe cases, severe speech disorders up to loss of voice can occur. As described above, the loss of the protective reflexes can lead to the swallowing of stomach contents into the lungs (aspiration). The acid gastric juice destroys lung tissue and causes inflammation.
This can lead to severe pneumonia, which requires intensive medical treatment. During the anaesthesia the muscle tone of the body is reduced, therefore it is important to ensure that all parts of the body are carefully positioned to prevent nerve damage (positioning damage). A very rare complication during anesthesia is malignant hyperthermia triggered by anesthetic gas. The body temperature rises rapidly and uncontrollably, which can lead to death.
