Complications in Anesthesia — Flashcards

Flashcard 21: The most common complication of a central line insertion below the clavicle is _____

Answer: Pneumothorax

Extra: For **subclavian vein** catheterization (infra-clavicular), **pneumothorax** is the most common mechanical complication (approx 1.5–3%). In contrast, for **internal jugular vein** catheterization, **arterial puncture** (carotid artery) is the most common complication (approx 6–9%).

Flashcard 22: The next best step in the management of vasospasm and gangrene following accidental intra-arterial thiopental administration is to leave the needle in place and administer _____ via the same needle.

Answer: Lidocaine (or Procaine) and Heparin

Extra: Management of accidental intra-arterial thiopental injection: 1. Leave the needle in place (in situ). 2. Dilute the drug with **Normal Saline**. 3. Relieve vasospasm with **Lidocaine**, **Procaine**, or **Papaverine**. 4. Prevent thrombosis with **Heparin**. 5. Sympathetic block (e.g., Stellate ganglion block) to maintain vasodilation. Note: Thiopental is highly alkaline (pH 10.5). Intra-arterial injection causes immediate vasospasm and endarteritis, which can lead to gangrene.

Flashcard 23: In laparoscopic pneumoperitoneum, a sudden drop in blood pressure and a characteristic "mill-wheel" murmur heard on esophageal stethoscope is suggestive of _____

Answer: Air embolism

Flashcard 24: Cardiac arrhythmia is an _____ sign of malignant hyperthermia

Answer: early

Flashcard 25: A sudden fall in EtCO2 with hypotension along with normal airway pressure during surgery is suggestive of _____.

Answer: CO2 embolism

Flashcard 26: Emergence reaction or delirium associated with ketamine is treated with _____.

Answer: Benzodiazepines

Flashcard 27: In case of venous air embolism (VAE), the patient should be placed in the _____ position.

Answer: Left lateral decubitus and Trendelenburg (Durant maneuver)

Flashcard 28: Succinylcholine and Inhaled anesthetics should be avoided in _____

Answer: malignant hyperthermia