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# Complications of General Anesthesia ## Preanaesthetic Medication This section describes the objectives and aims of premedication before administering anesthesia. **Objectives/Aims:** 1. Reduce anxiety and apprehension 2. Prevent vagal bradycardia and reduce salivary secretions 3. Relieve pr...

# Complications of General Anesthesia ## Preanaesthetic Medication This section describes the objectives and aims of premedication before administering anesthesia. **Objectives/Aims:** 1. Reduce anxiety and apprehension 2. Prevent vagal bradycardia and reduce salivary secretions 3. Relieve pre- and postoperative pain 4. Prevent vomiting 5. Prevent acid secretion and stress ulcers 6. Hasten gastric emptying **Drugs Used:** * BZDs (benzodiazepines) like diazepam, lorazepam, or midazolam (preferred for their anxiety-reducing effects and wide safety margin). * Antimuscarinic agents (e.g., atropine or glycopyrrolate) to prevent vagal bradycardia and hypotension, and also to prevent laryngospasm. Glycopyrrolate is preferred due to its potency, lack of significant CNS effects, and lower risk of tachycardia. * Opioid analgesics (e.g., morphine, pethidine, or fentanyl) to relieve pain. However, they may cause side effects such as respiratory depression, hypotension, nausea, vomiting, constipation, biliary spasm, and bronchospasm (especially in asthmatics). * NSAIDs (e.g., diclofenac) as an alternative to opioids for pain relief. * Antiemetics (e.g., metoclopramide, domperidone, ondansetron) to manage vomiting. * H₂-blockers (e.g., ranitidine) or proton-pump inhibitors (e.g., omeprazole) to prevent acid secretion and stress ulcers, especially before prolonged surgeries. * Prokinetic drugs (e.g., metoclopramide, domperidone) to hasten gastric emptying before emergency surgery. These increase lower esophageal sphincter tone and accelerate gastric emptying to prevent aspiration pneumonia. ## Conscious Sedation Conscious sedation is a level of CNS depression that allows patients to communicate and cooperate during a procedure. **Indications:** * Uncooperative patients * Anxious patients