Periop

Question 1

Assessment

Answer 1

• Heart
• Lungs
• Glands: diabetes, thyroid, Addison’s
• Kidney’s - CKD, Cr 170
• Blood - anaemia, DVT, PE, thrombocytopenia
• Liver - failure, HBV, HCV, HIV

*smoking cessation 4-8/52 to decrease resp and wound healing Cx

Question 2

Medications

Answer 2

• AC, AP - *stop warfarin 5/7 before OT, NOAC 2-3/7 before OT
• PO OHG - *stop 12/24 before OT, SGLT-2-I w/h 2/7 d/t risk of euglycaemic ketoacidosis - re-start 3/7 post OT
• Beta blocker
• Steroids
• Insulin
• ACE-I
• Anti-convulsants
• Analgesics

Question 3

High-risk surgery

Answer 3

• Intra-thoracic
• Abdominal
• Pelvic
• Vascular

Question 4

Goals of peri-OT diabetes Rx (4):

Answer 4

• Avoid hypos
• Avoid hypers
• Prevent DKA/HHS
• Maintenance of fluid and electrolyte balance