Alcohol Abuse




Risk




  • •

    Incidence in USA: 10% of Americans, incl physicians, will abuse alcohol at some point in their lives.


  • •

    1:5 surgical pts has some form of alcohol use disorder.


  • •

    Third leading cause of death and disability, incl 30% of traffic fatalities.


  • •

    Male gender and family Hx major are risk factors.





Perioperative Risks




  • •

    Severe malnutrition as significant as ETOH-induced end-organ injury.


  • •

    Risk of Htn, CVA, diabetes, GI disease.


  • •

    Liver is the most severely affected organ.


  • •

    Dilated cardiomyopathy.


  • •

    Withdrawal symptoms can be life threatening.





Perioperative Risks




  • •

    Severe malnutrition as significant as ETOH-induced end-organ injury.


  • •

    Risk of Htn, CVA, diabetes, GI disease.


  • •

    Liver is the most severely affected organ.


  • •

    Dilated cardiomyopathy.


  • •

    Withdrawal symptoms can be life threatening.





Worry About




  • •

    Concomitant use of other drugs: Amphetamines, cocaine, benzodiazepines.


  • •

    Affects of chronic smoking, such as COPD and emphysema.


  • •

    Vasopressor effect of ETOH may cause Htn.


  • •

    Acute withdrawal and delirium tremens are life-threatening complications. Symptoms caused by sympathetic stimulation can range from mild tremors to electrolyte disturbances, seizures, and death.





Overview




  • •

    Disease characterized by addiction (compulsion and craving despite consequences) to alcohol.


  • •

    Clinical syndromes related to direct effect of ETOH and secondary adaptive response to excess ETOH exposure.


  • •

    ETOH rapidly absorbed and metabolized.


  • •

    Hepatic dysfunction usually takes 10 to 15 y to develop.


  • •

    Cirrhosis may develop after 1 or more acute episodes.





Etiology




  • •

    Unknown: Likely mutifactorial with environmental, genetic, and psychosocial components


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Sep 1, 2018 | Posted by in ANESTHESIA | Comments Off on Alcohol Abuse

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