Preparation for Surgery Flashcards
when can patients drink fluids until?
2 hours before their operation
when should patients fast from?
6 hours before surgery
what are the potential complications of poorly managed diabetes during surgery?
- increased risk of wound and respiratory infections
- increased risk of post-operative acute kidney injury
- increased length of hospital stay
how is a patients on insulin with HbA1c <69 mmol/mol managed pre-operatively for minor procedures?
adjustment of their usual insulin regimen
how are diabetic patients managed in long surgeries (miss meals/dose)?
variable rate IV insulin infusion (VRIII)
how are poorly controlled diabetic patients managed preoperatively?
variable rate IV insulin infusion (VRIII)
how is metformin managed preoperatively?
day prior = normal
morning operation = normal
afternoon operation = normal
how are sulponylureas managed preoperatively?
day prior = normal
morning operation = omit
afternoon operation = omit
how are DPP IV inhibitors (-gliptins) managed preoperatively?
day prior = normal
morning operation = normal
afternoon operation = normal
how are GLP-1 analogues (-tides) managed preoperatively?
day prior = normal
morning operation = normal
afternoon operation = normal
how are SGLT-2 inhibitors (-flozins) managed preoperatively?
day prior = normal
morning operation = normal
afternoon operation = normal
how are once daily insulins managed preoperatively?
day prior = reduce dose by 20%
morning operation = reduce dose by 20%
afternoon operation = reduce dose by 20%
how are long-acting insulins managed preoperatively?
day prior = normal
morning operation = halve morning dose
afternoon operation = halve morning dose
what needs to be checked prior to thyroid surgery?
vocal cord check
what needs to be checked prior to parathyroid surgery?
methylene blue to identify gland
