PATIENT EVALUATION
PREOPERATIVE PHYSICAL EXAMINATION • Vital signs: Resting heart rate, BP, SpO2 height, weight, body mass index • CV & pulm: Heart & lung sounds, JVD, pulm/periph edema, carotid bruits • …
VENTILATION
CAPNOGRAPHY CO2 identified in expired gas by spectrographic properties (using IR, Raman, or mass spectroscopy) Hazards of Capnography: • Old in-line IR detectors can heat up, causing facial thermal injury…
FOR GENERAL SURGERY
ANESTHETIC CONSIDERATIONS IN ABDOMINAL SURGERY Preoperative Evaluation • Fluid status: Patients often hypovolemic • Inadequate fluid intake (fasting, anorexia) • Fluid loss (emesis, bowel preps, GI bleeding, fevers = insensible…
SYSTEM AND ANESTHESIA FOR UROLOGIC SURGERY
Acute Renal Failure • ↑ of Cr by ≥0.5 mg/dL or ↑ of Cr by ≥20% over 2 wks • Prerenal • Renal hypoperfusion resulting in ↓ GFR • Causes…
TRANSPLANTATION
ANESTHESIA FOR KIDNEY TRANSPLANTATION Indications • Polycystic kidney disease • Diabetes mellitus–related kidney failure • Hypertensive kidney disease • Glomerular disease • Tubulointerstitial disease • Other familial or congenital diseases…
OF ANESTHESIA
AIRWAY/DENTAL COMPLICATIONS Airway Complications Incidence • Unknown owing to varying significance/detection of injuries • Minor trauma to larynx & pharynx may be as common as 6% • Damage typically ↑…
ISSUES & EVENT DISCLOSURE
• Advance directive → instructions given by an individual specifying what should be done for his or her health should he or she no longer be able to make decisions…
FOR ORTHOPEDIC SURGERY
POSITIONING • Important to prevent tissue & nerve injury, especially in pts with arthritis & spine dz • Common peripheral nerve injuries occur with the following frequency: ulnar > brachial…
FOR THORACIC SURGERY
Bronchial Blockers • Bronchial blockers: May require longer to position & more intraop repositioning • Univent tracheal tube (provides CPAP, but cannot ventilate while isolating the lung) • Fogarty catheter…
