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Evaluation
Dr.Mohd Abdulshafi
Arab board
General Anesthesia
Definition:
Postoperative management
Preoperative management
Aim :
Is to ↓ perioperative morbidity and
mortality.
Establishment of Rapport.
Preoperative evaluation.
Informed consent
Premedication.
Pre operative visit.
It is considered negligence if
anesthetic morbidity or mortality
occurs subsequently.
When it should be done?
Thepreoperative basic health
assessment may be done anytime
within thirty days of the planned
procedure.
The purpose of a preoperative
evaluation
Isnot to "clear" patients for elective
surgery, but rather to evaluate and,
if necessary, implement measures to
prepare higher risk patients for
surgery.
It
can decrease the length of hospital
stay as well as minimize postponed
or cancelled surgeries.
Preoperative evaluation
History.
Examination.
Investigation.
Risk assessment.
1-HISTORY
Current medical problems and other
known problems.
Special habits.
Medical history.
Airway.
Nervous system.
4.ECG. (6 months)
Healthy patient > 40 years Add ECG and blood glucose (age >=45
years)
Cardiovascular disease. ECG, chest radiographs, hemoglobin,
electrolytes, BUN, creatinine, glucose (age
>=45 years or history of diabetes)
Prostate surgery
Patient-Related Predictors for Risk of
Perioperative Cardiac Complications
Major clinical Intermediate clinical Minor clinical
predictors predictors predictors Advanced
Myocardial infarction Mild angina pectoris age Abnormal
<=6 weeks previously Myocardial infarction electrocardiogram
Unstable angina >6 weeks previously Cardiac rhythm other