4 escores e fluxogramas Flashcards
Quais os Criterios de Lee (escore de Risco Cardiaco Revisado)?
- Coronariopatia
- Cirurgia de Alto risco (intra-peritoneal, intra toracica, vascular supra-inguinal)
- ICC
- Doenca cerebrovascular
- DM insulinodependente
- Doenca renal com Cr ≥ 2
“Cat Surgeons Couldn’t Breathe Inside Rats”
- coronary artery disease
- surgery (high risk)
- congestive heart disease
- brain (stroke)
- insulin dependent DM
- renal insufficiency (cr ≥ 2)
Cirurgia segura - checagem pre indução / sign-in (10)
- Alergias
- Antibiotico
- Consentimento
- VA Dificil
- Equipamento checado + pct monitorizado
- Jejum
- Vaga UTI
- Hemocomponentes
- Acesso IV
- Ja parou medicacoes (ex: anticoagulantes)
https://periodicos.ufba.br/index.php/cmbio/article/download/9196/6760
Ariscat
ABCDEFGH do anestesio
STOPBANG
Cirurgia segura - pre-incisao / time-out (6)
- Equipe de sala
- Local da cirurgia demarcado
- Equipamentos
- Sondagem
- Exames de imagem
- Material complementar
Cirurgia segura - após cirurgia / check-out (4)
- Contagem de compressas
- Encaminhamento para SRPA
- Soros, drenos e acessórios livres checados
- Algum equipamento com problema
Apfel NVPO
- Genero Feminino
- Nao-fumante
- Historia de NVPO ou
- Opioide pos-op
(UPTODATE). Perioperative pain management in adults
Preoperative evaluation
Does the patient have one or more risk factors for difficulty with pain management:
- Chronic opioid use
- Substance use disorder
- Prior history of difficult pain management
- High levels of pain-related anxiety
- Chronic pain
- Multiple allergies or intolerances to common analgesics or opioids?
https://www.uptodate.com/contents/image/print?imageKey=ANEST/139595&topi
*Neuraxial or peripheral block with or without a catheter, wound infiltration, or wound infusion.
¶ The expected degree of pain and time course of resolution vary with both patient factors and the type of surgery, and may be difficult to predict. In general, peripheral superficial procedures (eg, carpal tunnel release) should result in mild pain of relatively short duration; moderate pain should be expected after most laparoscopic and other minimally invasive surgeries and most soft tissue surgeries; and severe pain occurs after major open surgery, spine surgery, and arthroplasty.
Δ Use of gabapentinoids for postoperative pain is controversial and practice varies. Consider gabapentinoids for patients <75 years of age who undergo moderately to severely painful surgery.
◊ Consider ketamine for patients who would benefit from maximal opioid avoidance (eg, patients who are opioid tolerant, with opioid use disorder, or who have obstructive sleep apnea).
§ Consider lidocaine for patients who undergo spine surgery or open abdominal surgery when epidural analgesia is not used.
