Pre-op Assessment Flashcards
What are the reasons for pre-op anaesthetic assessments?
Reduces: Anxiety Delays Cancellations Complications Length of stay Mortality
What are the risks of general anaesthesia ?
Drug induced reversible coma
CNS, cardiac and respiratory depression
Drug interactions
What are the risks of regional anaesthesia?
Profound sympathectomy
Neurological sequelae
What is included in the pre-op history?
Known co-morbidities Unknown co-morbidities Ability to withstand stress Drugs and allergies Previous surgery and anaesthesia Potential anaesthetic problems
What method is used to classify the severity of anaesthetic risk?
ASA grading
What conditions are included in the cardiac risk index?
High risk surgery Ischaemic heart disease Congestive heart failure Cerebrovascular disease Diabetes Renal failure
What possible cardiovascular investigations should be considered before surgery?
ECG Exercise tolerance test Echo Myocardial perfusion scan Stress echo Cardiac catheterisation CT coronary angiogram
What possible respiratory investigations should be considered before surgery?
Saturations ABG CXR Peak flow measurements FVC/FEV Gas transfer CT chest
What conditions should have optimal medical control prior to surgery?
Hypertension Ischaemic heart disease Heart failure Asthma COPD Diabetes Epilepsy
What medications should be stopped prior to surgery?
Anti-diabetic medication
Anticoagulants (switch to dalteparin)
