Patient Information Leaflet GENERAL ANAESTHETIC This leaflet has been designed to improve your understanding of the possible risks associated with a general anaesthetic. If you would like further explanation please ask. RISKS THAT CAN RESULT IN SIGNIFICANT INJURY AND DISCOMFORT Risk Comment / Explanation Sore throat Bruised throat Broken teeth Cut lips Nose bleed Trauma to teeth, lips, tongue, gums and nose Muscle pains Arms, legs Skin bruising Intravenous line Nausea With or without vomiting Pain Wound pain Airway injury Injury to throat, larynx, trachea Aspiration pneumonia Injury to lungs Lung collapse Atelectasis Lung infection Eye damage Corneal abrasion Awareness Patient not fully asleep Confusion Agitation Due to tubes inserted in the throat and airway to support breathing. Worse in people prone to bruising because of a medical condition or its treatment. Caused by the instruments and tubes needed to maintain the airway and breathing and by susceptible patients biting on these tubes. Caps, crowns and decayed teeth especially at risk but tooth damage can happen to anyone. Lips and gums can be bruised or cut. Worse in people prone to bruising because of a medical condition or its treatment. Some anaesthetic drugs or prolonged immobility on the operating table can result in significant muscle pains lasting for days. Insertion or removal of an intravenous line or canula can result in bruising and other damage to the skin. The wound may, on rare occasions, become infected and need antibiotic or surgical treatment to remedy it. Worse in people prone to bruising because of a medical condition or its treatment. Due to individual patient susceptibility, anaesthetic drugs, pain killing (analgesic) drugs and duration of the operation. Severe vomiting may result and may require admission to hospital for further treatment. May be difficult to treat due to individual susceptibility or intolerance of pain killing drugs. Injury caused by airways, tracheal tubes and instrumentation and manipulation of airway. Swelling, laceration and paralysis of structures in the throat and trachea. Tracheal stenosis from an endotracheal tube. At worst these problems can cause significant injury to the airway resulting in admission to intensive care and operations to repair the injury. Aspiration (inhalation) of stomach contents into the lungs. Despite fasting for the operation the stomach may not be empty or may not empty properly into the intestine. Any material in the stomach may regurgitate or be incompletely vomited and end up being inhaled into the lungs. Secondary infection further compounds this problem. The resulting damage to the lungs may result in severe inflammation and can be fatal Significant collapse of parts of the lungs can occur because of the anaesthetic or patient susceptibility. Lung infection may complicate this. Can occur in any age group but more common in overweight people and tobacco smokers. Can vary in severity. At worst it can result in difficulty breathing and admission to intensive care. Injury to the cornea due loss of the protective blink reflex and direct injury by foreign objects or excessive rubbing or scratching can result in significant injury to the cornea or surface of the eye. The patient may not be fully anaesthetised (asleep) due to equipment (machine) faults, drug errors, individual susceptibility and human error. Due to effects of anaesthetic and pain killing drugs, withdrawal of medication or individual susceptibility. Worst at the extremes of age but especially in the elderly. Cognitive decline in the elderly after anaesthesia and major operations is a well described problem. MAJOR LIFE-THREATENING RISKS Risk Comment / Explanation Death Cardiac arrest Occurs between 1:200,000 to 1:400,000 cases Severe reaction to the anaesthetic or other drugs due to anaphylaxis, malignant hyperpyrexia or rise in blood potassium. Heart attack due to unknown or known pre-existing heart disease. Acute pulmonary embolus (clot in the lung). Acute stroke. Can occur ‘out of the blue’ or in people susceptible to a stroke. Cardiac arrest secondary to other injuries such as electrolyte changes, kidney failure or neurological problems. Significant injury Brain damage Blindness Seizures Oxygen and equipment failure or human error. Cardiac arrest with circulatory arrest. Reactions to and interactions with anaesthetic drugs, antibiotics and other drugs (malignant hyperpyrexia, anaphylaxis). Acute stroke. A stroke can occur ‘out of the blue’ in previously healthy people (of any age) or can occur as a result of any of the above complications of an operation and anaesthetic. Paralysis of limbs Nerve damage Spinal cord or severe nerve damage due to manipulation of neck, compression or stretching of nerves or inadvertent injection of drugs into a nerve. Result is paralysis and/or numbness of part or all of the arms or legs or other part of the face and body. Broken neck Due to manipulation (movement) of the neck in people with pre-existing known or undiagnosed neck disease. Kidney failure Kidney damage in people with known or unknown kidney disease. Some people have kidney impairment without knowing it. Damage is due to drugs and reactions to general anaesthetics. Skin loss Due to inadvertent injection of drugs or fluids outside a vein and into the tissues. May result in skin grafting and scarring of the skin needing plastic surgery to repair the problem. This leaflet is available online at http://www.ucc.ie/en/dentalschool/patients