Perioperative Care Flashcards
What do you do with Clopidogrel prior to surgery?
Stop 7 days before surgery
What do you do with Aspirin before surgery?
Continue as benefits outweigh risks
What do you do with beta blockers before surgery?
Continue
What do you do with oral hypoglycaemics before surgery?
Stop from day of surgery
What do you do with the OCP or HRT before surgery?
Due to DVT risk, stop 4 weeks before surgery then resume 2 weeks after surgery
What do you do with corticosteroids before surgery?
Continue as it could lead to Addisonian crisis
What do you do with Warfarin before surgery?
Stop 5 days before surgery
How can you reverse Warfarin in an emergency?
Beriplex (synthetic factors 2,7,9,10)
IV Vit. K
Which drugs are given before surgery?
Prophylactic SC LMWH
Prophylactic antibiotics
-Cefuroxime, Metronidazole or Augmentin
Which drugs are given post operatively?
Opiates +/- laxative if >3days
NSAIDs
What is the general triad of anaesthesia?
Hypnosis
Analgesia
Muscle relaxation
Give 4 causes of confusion after surgery?
Hypoxia Drugs (opiates, sedatives etc. ) Urinary retention MI/Stroke Infection Alcohol withdrawal Liver/renal failure
Give 4 general post-op complications?
Pyrexia Confusion Dyspnoea/hypoxia Hypo/hypertension Oliguria Nausea & Vomitting Bleeding
What are the risk factors for a DVT? 4 things
Elderly Pregnancy OCP/HRT Surgery Past DVT Obesity Immobility
Name 3 causes of bilateral oedema?
Right heart failure Low Albumin Venous insufficiency Use of vasodilators Pelvic mass Pregnancy
Give 2 early and 2 late complications of stomas?
Early Haemorrhage at site Stoma ischaemia Obstruction secondary to adhesions Stoma retraction
Late Dermatitis around site Stoma prolapse Stenosis Fistulae Psychological problems
Give 3 early and late blood transfusion complications?
Early Haemolytic reaction Anaphylaxis Febrile reaction Fluid overload
Late
Blood borne infections
Iron overload
Post transfusion purpura
Give 2 alternatives to blood transfusion?
Intra operative cell salvage
Post op autologous transfusion
What are the signs of Shock?
Sinus tachycardia >100 Hypotension Oliguria Cold Klammy Slow cap refill
Give 4 risk factors of PONV?
Type of surgery (gynae, urological, middle ear etc. ) Female Previous Hx Obesity Anxiety pre-op Motion sickness
How can you prevent DVT during/after surgery?
Compression stockings
LMWH
Name 4 complications that could arise from an epidural?
Respiratory depression Hypotension Epidural haematoma Epidural catheter migration Epidural abscess Urinary retention N&V
