Neurologic Complications of Anesthesia
Neurologic complications of anesthesia are not common, but when they occur, they are very serious and severe to patients. Major complications that result from anesthesia are intracranial high blood pressure that is intraoperative, cognitive disfunctioning and delayed response to arousing conditions (Cousins, Michael & Phillip 123). This mostly happens to patients suffering from brain masses. Evaluation by neurologists is done to patients that have postoperative signs and symptoms. This helps to distinguish between symptoms and signs that result from an anesthetic drug and those that are not caused by the drug. Cases of neurologic complications are so severe that neurologists advocate for consultations in postsurgical settings to give advice to patients who may be victims of this severe monster once they undergo their surgeries. This is what happens within the American Society of Regional Anesthesia and Pain Medicine (ASRA) organization (Baehring, Joachim and J M. 245). Therefore, this research focuses on this body to understand the issues of neurologic complications of anesthesia.
Statement of the Problem
Practitioners of both regional anesthesia and pain medicine do not have enough relevant information required to curb the severe complications associated with the disease (Wen, Patrick , David and Eudocia 342). Though not common in the society, it does not give way for medical dealers and physicians to ignore the issue. Instead, they would be concerned to know more about the issue so that in the near future, there will be no chances of it being a disaster to people. This is because, when it does not affect many people, it becomes easier to identify the similarity of the symptoms and signs. Many cases of such complications in many people will pose challenges in aligning what all of them will be undergoing.
Purpose of the Study
This study helps in providing the practitioners with accurate and enough information concerning etiology, different ways of diagnosing the disease, ways to prevent it as well as how to treat complications associated with neurologic Anesthesia. This will equip them with knowledge that will help in coming up with better ways of dealing with the disease.
Significance of the Study
The study will benefit the patients who suffer from these complications. They will be properly attended to with the better ways that medical dealers and neurologists will come up with using the information provided. The governments in certain countries where such cases arise will also benefit. They will save revenue that is spent in finding solutions to the complications. Among the solutions they go for, is to buy expensive medical scanners and x-ray machines they think would help in curbing such cases. In most cases, these machines do not help because they are not the right ones to diagnose the disease. With the accurate information, they will be able to purchase the right tools and machines for the work.
The research questions of this study will be:
- What reliable and consistent data reveals the severity of the disease?
- Are there any unrelated factors to Anesthesia that cause these complications?
- What is the diagnosis and treatment of the complications?
Many researchers have employed their interest in the field of medicine, specifically on the issue of Anesthetic neurologic complications. However, they always face a common challenge they are not able to solve in the process of their studies and researches. The infrequent cases of Anesthetic complications make them take long to administer their procedures in researching of the complications (Schiff et al. 137). This makes them gather little information they take long to sum up because they have to wait for such cases to emerge in any part of the world always. The other challenge that researchers face in their studies is that injuries bias data that is based on insurance as well as Medico legality. Underreporting on the other hand, biases data that is obtained from clinics where Anesthetic neurologic complications may occur (Simon et al. 50). American Society Anesthesiologists (ASA) conducted a similar research on this issue and released some data.
However, the data suffered from overestimation from the injuries that occurred while the clinical studies that were made, underestimated the truth of the incidence. From the studies that ASA conducted, it was revealed that patients are subjected to the risk of permanent injuries within a range of 42% to 77%, when they narrowly escape death from the severe complications. During the past years, serious case of neurologic injuries that ASA observed were said to take place in 2.4 in every 10000 nerve blocks (Valchanov et al. 234). Symptoms and signs of these complications in the body emerge within few days, to a few weeks after their development in patients. The longest time that symptoms and signs of Anesthetic neurologic complications can show is one year, according to ASA. The organization stated that the more the patients take long to be on medication for the complications, the more severe the matter becomes with time (Goldman, Stewart & Christopher 287).
Closed Claims Projects conducted studies in Sweden in clinics to gather some information on this issue too. From the data they obtained, they suggested that the rate at which Hematoma, another complication that is an outcome of the complications, ranges from 1.3% to 2.7% in every 100000 patients. This is a confidence Interval of 95% (White and Deborah 99). Hematoma and other complications that are infectious and result from Anesthesia are the common compared with the Syndrome of anterior spinal artery (ASA). For instance, in over 70000 neural anesthetics conducted in France, no single case was reported about injuries of the spinal cord (Chestnut 342).
Several keywords used in the study are nerve injury, which is the damage caused to the nerve tissue that sends signals to the brain. Spinal and epidural anesthesia are drugs that are used to numb the body to avoid the patient from feeling any pain. Peripheral nerve blocks are techniques that involve blocking certain nerves to prevent certain infections and complications to certain body parts (Finucane 172). Regional anesthesia is anesthesia that attacks a large part of the body, such as completely the lower part. The technique applied involves subjecting that specific affected part to surgical stimuli (Chelly 198). Pain medicine is the ways that physicians and other medical dealers apply their medical knowledge to manage pain in the bodies of patient who suffer from different diseases.
The ASRA is an organization that aims at conducting studies on neurologic injuries to provide information that is relevant to neurologists to handle complications associated with neurologic complications properly (Neal, Joseph & James 254). ASRA chooses an attorney and a panel that has expertise in issues on Anesthesia and invites them to make their contributions. The panel is later sent to conduct studies it compares with the studies they conduct. The interests observed from the two sides are later published as advice to all stakeholders of this issue. The literature obtained is summarized and presented during conferences that the organization holds to deliver the message on this monster. The summary is also produced in manuscripts regarding the scholarly works of the panel (Wiley 367). Though the cases are infrequent, the panel made great attempts to provide relevant information that helps the neurologists’ body to handle the matter of neurologic complications.
Data that was collected in clinics and hospitals indicate that cases of such complications are very rare but when they occur, they land heavily on patients, causing severe results to their health and lives as well. The many patients that have die of worries from this issue. It ranges from 42% to 77% of all severe deaths that are recorded in the world (Usubiaga 412). For the few that miss death, they are left permanently damaged and paralyzed in their beds. The study reveals that only patient-risk factors lead to these complications. Some may be related to the disease and others may not. These complications mostly affect patients that have been diagnosed with brain masses. However, they also result due to other factors such advanced age and male gender as part of social life of individual may lead to these complications.
Other health factors such as past diagnoses with neurologic disorders, diabetes mellitus could extend their effects to the patient by such complications. Surgical risk factors that may cause these complications are wrong patient positioning, dressings that are compressive to the patient, trauma or stretching after a surgery to the patient and perioperative inflammation (DeAngelis, Lisa & Jerome 177). Diagnosis of the complications should be done immediately symptoms and signs of Anesthesia are detected. This will first involve subjection of the symptoms to close examination and tests. An excellent prognosis is obtained when symptoms start to resolve. If symptoms do not resolve /improve, some consultation to a neurologist is advocated for within the next two or three weeks. Once a person is diagnosed with the complications, neurophysiologic testing is done to help in determining the amount of damage that has been caused to the nerves, or any other body part. In the following three to five months, the patient undergoes unresolved lesions. If no improvement is noted, the body part or nerve is subjected to further surgical exploration for further analyses.
Data analysis and Results
From the statistical data that has been previously stated, the severity of complications of anesthesia is seen. It is evident that though such cases are rare, they cause the highest percentage of severe deaths (Atlee 164). This calls for more examination of the complications to avoid these deaths.
Discussion about the Results
These findings support the existing theories and beliefs about complications of anesthesia. This is because the panel as well as ASA conducted researches and studies in different parts of the world where the cases were recorded. The commonness in all the cases recorded maps the truth, clarity and accuracy of the findings on what has been initially observed by past researchers. The study is also valid because its getting concentrated in clinics and hospitals, which are the core settings of the profession of health care. Recommendations go to the panel and the attorney that helped to understand neurologic complications better (Suresh, Maya, Sol and Gershon 57). However, they cannot give an assurance that there will be no adverse outcomes of such complications. The recommendations are that the panel provided information that limiting, diagnosing and treating neurologic complications will be made possible and easy.
List of Appendices
Past information on complications of anesthesia………,,,,……………… pg 3,4
Diagnosis and treatment of the complications……………,,,,,,…………… pg 5
Causes of Complications of
anesthesia………………………,,,,,,………… pg 6
Atlee, John L. Complications in Anesthesia. Philadelphia: Elsevier/Saunders, 2007. Print.
Baehring, Joachim M, and J M. Piepmeier. Brain Tumors: Practical Guide to Diagnosis and Treatment. New York: Informa Healthcare, 2007. Print.
Chelly, Jacques E. Peripheral Nerve Blocks: A Color Atlas. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2009. Print
Chestnut, David H. Obstetric Anesthesia: Principles and Practice. St. Louis: Mosby, 2004. Print.
Cousins, Michael J, and Phillip O. Bridenbaugh. Cousins and Bridenbaugh’s Neural Blockade in Clinical Anesthesia and Pain Medicine. Philadelphia: Lippincott Williams & Wilkins, 2009. Print.
DeAngelis, Lisa M and Jerome B. Posner. Neurologic Complications of Cancer. Oxford: Oxford University Press, 2009. Internet resource.
DeAngelis, Lisa M, Jerome B. Posner, and Jerome B. Posner. Neurologic Complications of Cancer. Oxford: Oxford University Press, 2009. Internet resource.
Drevelegas, Antonios. Imaging of Brain Tumors with Histological Correlations. Berlin: Springer, 2011. Internet resource.
Finucane, Brendan T. Complications of Regional Anesthesia. New York, N.Y: Springer, 2007. Internet resource.
Goldman, Stewart, and Christopher D. Turner. Late Effects of Treatment for Brain Tumors. New York: Springer, 2009. Print.
Neal, Joseph M, and James P. Rathmell. Complications in Regional Anesthesia and Pain Medicine. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2013. Print.
Schiff, David, Santosh Kesari, and Patrick Y. Wen. Cancer Neurology in Clinical Practice: Neurologic Complications of Cancer and Its Treatment. Totowa, NJ: Humana Press, 2008. Print.
Simon, Robert R, and Barry E. Brenner. Emergency Procedures and Techniques. Philadelphia, Pa: Lippincott Williams & Wilkins, 2001. Print.
Suresh, Maya, Sol M. Shnider, and Gershon Levinson. Shnider and Levinson’s Anesthesia for Obstetrics. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins Health, 2013. Print
Usubiaga, José E. Neurological Complications Following Epidural Anesthesia. Boston: Little, Brown, 1975. Print.
Valchanov, Kamen, Stephen T. Webb, and Jane Sturgess. Anaesthetic and Perioperative Complications. Cambridge: Cambridge University Press, 2011. Print
Wen, Patrick Y, David Schiff, and Eudocia Quant. Neurologic Complications of Cancer Therapy. New York: demos Medical, 2012. Print.
White, Barbara, and Deborah Truax. The Nurse Practitioner in Long-Term Care: Guidelines for Clinical Practice. Sudbury, Mass: Jones and Bartlett, 2007. Print.
Wiley, Ronald G. Neurological Complications of Cancer. New York: M. Dekker, 2005. Print.