Anaesthetics - Pre-operative Assessment

Question 1

Post-operative side-effects of anaesthesia

Answer 1

• General
  
  • Drug-induced reversible coma
  • CNS, cardiac and respiratory depression
  • Drug interaction
• Regional anaesthesia
  
  • Profound sympathectomy
    
    • Neurological sequelae

Question 2

Pre-operative role of the anaesthetist

Answer 2

• Assessment
• Identify high risk factors
• Optimise patients health
• Minimise risk
• Inform and support patient decisions
  
  • Consent

Question 3

When is pre-op assessmen carried out

Answer 3

• Elective surgery → primary care, pre-op Clinical
  
  • Still required in urgent and emergency surgery

Question 4

Important aspects of pre-operative history

Answer 4

• Severity of co-morbidities
• Control of co-morbidiites
• Exervise tolerance test
  
  • Problems with → airways, spine, reflux, obesity

Question 5

Pre-operative investigations

Answer 5

• Cardiovascular
  
  • ECG
  • Exercise tolerance test
  • Cardiac catheterisation
  • ECHO
  • CT coronary angiogram
• Respiratory
  
  • Saturation
  • CXR
  • ABG
  • Peak flow measurement
  • FVC/FEV1
  • Gas transfer
  • CT chest

Question 5

Pre-operative investigations

Answer 5

• Cardiovascular
  
  • ECG
  • Exercise tolerance test
  • Cardiac catheterisation
  • ECHO
  • CT coronary angiogram
• Respiratory
  
  • Saturation
  • CXR
  • ABG
  • Peak flow measurement
  • FVC/FEV1
  • Gas transfer
  • CT chest

Question 6

Factors that need to be optimised before surgery

Answer 6

• Hypertension
• Ischaemic heart disease
• Heart failure
• Asthma
• COPD
• Diabetes
• Epilepsy
• Obesity
• Smoking
  
  • Alcohol