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    Anesthesia Lecture 1

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    drhiwaomer
    Preoperative evaluation and preparation for anesthesia begins when the anesthesiologist reviews the patient’s medical record and visits the patient the day before elective surgery

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    Attribution Non-Commercial (BY-NC)
    Download as PPT or read online from Scribd

    Anesthesia Lecture 1

    Uploaded by

    drhiwaomer
    654 views16 pages
    Preoperative evaluation and preparation for anesthesia begins when the anesthesiologist reviews the patient’s medical record and visits the patient the day before elective surgery

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    anesthesia lecture 1

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    © Attribution Non-Commercial (BY-NC)

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    Preoperative evaluation and preparation for anesthesia begins when the anesthesiologist reviews the patient’s medical record and visits the patient the day before elective surgery

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT or read online from Scribd
    Download as ppt
    654 views16 pages

    Anesthesia Lecture 1

    Uploaded by

    drhiwaomer
    Preoperative evaluation and preparation for anesthesia begins when the anesthesiologist reviews the patient’s medical record and visits the patient the day before elective surgery

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPT or read online from Scribd
    Download as ppt
    of 16

    Preoperative Evaluation and

    choice of Anesthetic Technique

    Preoperative evaluation and preparation for


    anesthesia begins when the anesthesiologist
    reviews the patient’s medical record and visits
    the patient the day before elective surgery
    Important aspects of the
    preoperative evaluation include:
    • History
    • Review of current drug therapy
    • Physical examination
    • Interpretation of laboratory data
    • Consent
    • Planned management of anesthesia
    • Methods available for relief of post operative pain
    • Fasting
    • Assignment the physical status classification
    • Premedication
    History
    • Previous adverse responses related to anesthesia
    2. Allergic reactions
    3. Prolonged skeletal muscle paralysis
    4. Delayed awakening
    5. Nausea and vomiting
    6. Hoarseness
    7. Myalgia
    8. Hemorrhage
    9. Jaundice
    10. Post spinal headache
    11. Adverse responses in relatives
    • Central nervous system
    2. Cerebrovascular insufficiency
    3. Seizures

    • Cardiovascular system
    6. Exercise tolerance
    7. Angina pectoris
    8. Prior myocardial infarction
    9. Hypertension
    10. Rheumatic fever
    11. Claudication
    12. dysrhythmias
    • Lungs
    2. Exercise tolerance
    3. Dyspnea and orthopnea
    4. Cough and sputum production
    5. Bronchial asthma
    6. Cigarette consumption
    7. Pneumonia
    8. Recent upper respiratory tract infection
    • Liver
    2. Ethanol consumption
    3. Hepatitis

    • Kidneys
    6. Nocturia
    7. Pyuria

    • Skeletal and muscular systems


    10. Arthritis
    11. Osteoporosis
    12. Weakness
    • Endocrine system
    2. Diabetes mellitus
    3. Thyroid gland dysfunction
    4. Adrenal gland dysfunction

    • Coagulation
    8. Bleeding tendency
    9. Easy bruising
    10. Hereditary coagulopathies
    • Reproductive system
    2. Menstrual history
    3. Sexually transmitted diseases

    • Dentition
    7. Dentures
    8. Caps
    Drug usage and potential interactions with
    drugs administered in the Perioperative
    period

    Alcohol abuse • tolerance to anesthetic


    drugs

    Antibiotics • Prolongation of muscle


    relaxants

    • Impaired sympathetic
    Antihypertensive nervous system
    responses
    Aspirin • Bleeding tendency

    Benzodiazepines • Tolerance to
    anesthetic drugs

    Beta antagonists • Bradycardia


    • Bronchospasm
    • Impaired sympathetic
    nervous system
    responses
    • Myocardial
    depression
    Calcium channel blockers • Hypotension

    Digitalis • Cardiac dysrhythmias or


    conduction disturbances

    Diuretics • Hypokalemia,
    Hypovolemia
    • Exaggerated response to
    Monoamine oxidase
    sympathomimetic drugs
    inhibitors
    with acute treatment

    • Exaggerated response to
    Tricyclic antidepressants sympathomimetic drugs
    with acute treatment
    Physical examination
    • Central nervous system
    1. Level of consciousness
    2. Evidence of peripheral sensory or skeletal
    muscle dysfunction
    • Cardiovascular system

    3. Auscultation of the heart (heart rate, rhythm,


    murmur)
    4. Blood pressure (supine and standing )
    5. Peripheral pulses (arterial cannulation site)
    6. Veins (access site)
    7. Peripheral edema
    • Lungs
    2. Auscultation of the lungs (rales, wheezes)
    3. Pattern of breathing
    4. Anatomy of thorax (emphysema)
    • Upper airway
    2. Cervical spine mobility
    3. Temporomandibular mobility
    4. Prominent central incisors
    5. Diseased or artificial teeth
    6. Ability to visualize uvula
    7. Thyromental distance
    • Coagulation
    Bruising
    Petechiae

    Thank you

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