Peri-operative Care Flashcards
how many days prior to surgery should clopidogrel be stopped
7 days
what mood stabilising drug should be stopped before surgery
Lithium (24 hours before)
what antihypertensive should be withheld on the day of surgery
ACE inhibitors
how many days prior to surgery should warfarin be stopped
5 days
management if INR is <1.5 prior to surgery
proceed
management if INR 1.6 - 1.7 prior to surgery
1mg oral vitamin K
management if INR >1.8 prior to surgery
2mg oral vitamin K
should the combined oral contraceptive pill be stopped prior to surgery?
yes for big procedures under GA
no for minor procedures
what are the consequences of poorly controlled glucose in the peri-operative period
increased risk of wound infection
increased CV complications
irreversible brain damage
what do type 1 diabetics require during surgery
IV insulin infusion + dextrose + potassium chloride
when should normal insulin be given in a post-op Type 1 diabetic patient
subcutaneous insulin given post op once the patient has eaten
- continue insulin infusion for one hour post s/c insulin
Should insulin be withheld prior to surgery
no- continue medication as normal until day of surgery
place first on operating list
commence insulin infusion
what class of diabetic drug should be withheld on the day of surgery
Sulfonylureas - e.g. gliclazide
- resume once patient eating normally
