Preoperative Assessment Flashcards
When to do pre-op consultation?
Depends on the patient and the procedure, could be between right before or months in advance
propofol increases risk of?
strokes
how does anaesthetic affect stenosis?
get worse with venodilation
how does anaesthetic affect regurg?
gets better
what does anaesthetic do to respiratory FRC?
decrease by 30%
need how many METS to tolerate surgery?
4 METS
how much is 3-ish METS?
dishes
walking around block
Stairs
How does RA affect anaesthetics re: Neck, resp, circulation
Neck: stiffness, AA instability, TMJ: intubation hard
Breathing: pulmonary fibrosis
Circulation: IHD and atherosclerosis
How does alcohol affect anaesthetic dosage?
acute intoxicated: less
chronic intoxication: more b/c of tolerance
what is Mallampati classification about?
Uvula visibility for intubation
Thyromental distance should be?
~7cm
what cardio optimization before surgery?
uncontrolled IHD, CCF, Valvular
what respiratory optimization before surgery?
Smoking, COPD, asthma
what endocrine optimization before surgery?
diabetes, thyroid disease
what renal optimization before surgery?
dialysis
what haematological optimization before surgery?
anaemia, anticoagulation
4 broad categories of anaesthetics?
Local
Regional: Nerve Block, epidural
Sedation
General
what is PONV?
Post-Operative Nausea and Vomiting
what is an antisialagogue?
anti-secretions, like atropine
advantages of general anaesthetics?
will lie still
advantages of spinal blocks?
brain not affected
better if asthma or COPD
less post-op confusion
what kind of pain management post-op?
multi-modal management
what to do if someone on warfarin preop?
5 days prior, stop, then cover with clexane whiach at halflife of 6-12 hours
3 things to reverse warfarin:
prothrombinex: 10 min
Vit K: a day or so
FFP: 30 minutes
