Current Challenges in Anesthesia

Anesthesia is a crucial procedure during surgery. It is a treatment administered to patients to prevent pain when undergoing an operation. Ideally, doctors use anesthetics drugs to induce the patient into a temporary loss of consciousness and feeling. However, there seem to be challenges facing anesthesia.

Comorbidities complications confront professionals in this field, especially with senior patients who depict complex signs like vomiting, nausea, and delirium after anesthesia. But with the availability of now multiple anesthetic drugs, safe care is guaranteed. Patients can now have procedures done safely and without long-term anesthesia effects. Innovative methods, such as opioid techniques, have been introduced to enhance safe care while administering anesthesia.

Management of Acute and Chronic Pain

However, these opioids’ innovation is under close monitoring of the Food and Drug Administration (FDA). For instance, the FDA has raised concerns about labeling the naloxone meant for acute and chronic pain. Thus, all opioids for the management of chronic or acute pain must have labels.

Sleep Effects

A report on chronic opioids and sleep indicates opioids as a potential risk factor. These medications are said to cause respiratory depression, hypopnea and apnea, and altered sleep architecture. A polysomnography study confirmed chronic opioid therapy to have these unpleasant effects on sleep. However, airway pressure therapy is recommended for any patients who show symptomatic sleep disorders after chronic opioids.

Management of Airway

COVID-19 has also posed a challenge to many patients. But, the use of protective barriers when handling Covid-19 patients has been highly recommended by the FDA. Manifold prototype devices have been invented to enhance the protection of health care workers. Knowing the risks associated with droplets for Covid-19 patients, health professionals need to be safe when intubating and extubating patients. However, the challenge is the personal protective equipment used, protected from aerosol and droplets. There were concerns about the right precautions to be employed in airway management for Covid-19 patients.

Ideally, airway management increases the exposure and transmission of Covid-19 through the aerosol procedure. Clinicians are advised to use high-level protection gear. Gown, eye protection equipment, gloves, powered air-purifying respirator, or N95 respirator are some of the recommended personal protective equipment for use while managing anesthesia in patients with airway conditions.

Safety of Patients

There is temporary approval for emergency use of higher-dose propofol to enhance patients’ safety. The approved dosage is 2 percent (20mg/ml) for ICU patients over 16 years of age. However, the approval is meant to offer relief during the Covid-19 pandemic. Given that the dosage approved by FDA contains a high concentration of the products used, there seems to be a challenge. The Examination Under Anesthesia (EUA) reports the unavailability of products needed for propofol 1 percent (10 mg/mL). Thus, there is a vital need to update the labeling in the medication pump libraries and automated order sets to avoid an unintended overdose. That will keep the patients under anesthesia safe.

Critical Care After Surgery

Mortality rates seem to be increased by resistance seen in some patients. For instance, reports indicate that some refuse to have a blood transfusion. That requires prompt action to help in the provision of care in life-threatening anemia cases. The use of hemoglobin-based oxygen carriers has been recommended, and this has helped reduce the mortality rate.

Emergency Surgical Cases

Though the COVID-19 epidemic has paralyzed many of the operations in the healthcare industry, emergency procedures are indispensable. For instance, electroconvulsive therapy (ECT) on individual patients. The technique used on these patients poses high exposure of aerosol to the involved anesthesia providers. But strategies and special precautions have been implemented to lessen infection risk on the clinicians during anesthesia.

Proper hygiene and the efficient use of personal protective equipment is an essential part of patient management. It safeguards the perioperative professionals from contracting infectious diseases during anesthesia management. Thus, with the current pandemic challenges, guidelines have been issued to improve the management of Covid-19 patients and suspected cases. These directives include airway management, safety measures for an anesthesia machine and other devices, and PPE use.