Perioperative Management Flashcards
ASA classification higher than class ___ (meaning class ___ and above) means _____ times increased risk for post op pulmonary complications
Higher than class II.
Meaning class III and above.
= 2-3 x increased risk
ASA Classification
I
II
III
IV
V
VI
I. healthy
II. mild or severe but controlled (controlled diabetes)
III. severe
IV. severe and threat to life
V. moribund patient who cannot survive without surgical attempt.
VI. braindead
For patients with uncontrolled asthma or COPD, consider what in post-op period?
inhaled bronchodilators, corticosteroids, chest PT (physical therapy)
If a patient has a pacemaker then be mindful of
cautery risk
Maintain glucose at
80-100 mg
Glucose med control for diabetes
Type I- do NOT stop basal insulin before surgery
Type II- hold orals before surgery
Metformin peri-op control
stop 48 hours before and restart 48-72 hours after
Pre-op Creatinine levels of ___ increase risk for acute renal failure
> 2.0
Dialysis to be performed ___ day prior to surgery unless emergent
1 day
PAD increases risk of post-op complications by ___ times
6 times
Supplement pre-op steroids if patient has taken steroids for…
more than 2 weeks in last year
Rheumatoid patients, order
cervical x-ray to assess atlantoaxial subluxation
Bupivacaine duration vs Lidocaine
4-8 hrs vs 1-2 hours
Toxic doses Bupivacaine
plain 175 mg
don’t exceed 2.5 mg/kg
w/epi 225 mg
don’t exceed 3.2 mg/kg
note Bupivacaine comes in 0.5%
Equation for % to mg to cc conversation
1% = 10mg/1cc(mL)
