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PreOperative Evaluation and Care

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Correct preparation ... of body weight and height. Pre-Operative Evaluation ... Fasting for 4 to 6 hours to prevent vomiting and dangers of aspiration of ... – PowerPoint PPT presentation

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Title: PreOperative Evaluation and Care


1
Pre-Operative Evaluation and Care
2
Purpose of Pre-Operative Evaluation
  • Establishment of rapport with patient
  • Evaluation of laboratory investigations already
    done and to advise for further investigation, if
    required
  • Evaluation of co-existing diseases (if any)
  • Assessment of risk-benefit ratio about anesthesia
    and surgery and postponement of surgery if needed
  • To advise pre-operative instructions
  • Planning for anesthesia

3
Purpose of Pre-Operative Evaluation
  • Pre-operative evaluation includes
  • History A full medical history
  • Physical examination
  • Investigations
  • Correct preparation for the operation
  • Ensuring adequate facilities and trained staff
    for operation

4
Pre-Operative History Taking
  • Current medical history
  • Anesthetic history
  • Family history
  • Drug history
  • Allergies
  • Smoking and alcohol habits
  • History of HIV or hepatitis
  • History of co-existing disease

5
Pre-Operative Physical Examination
  • Examination of airway, oral cavity, denture,
    neck, etc.
  • Examination of area over vertebral column
  • Examination of skin of area where spinal
    anesthesia is to be performed
  • Auscultation of heart and lungs
  • Measurement of pulse rate and blood pressure
  • Measurement of body weight and height

6
Pre-Operative Investigations
  • Hemoglobin estimation
  • Routine urine examination
  • Random blood sugar/post-prandial blood sugar, if
    diabetic
  • Electrocardiogram and chest x-ray, if patient
    hypertensive or history of ischemic heart disease
    or chronic obstructive pulmonary disease
  • Other investigations as required

7
ASA Grading
  • Grade I Normal healthy patient
  • Grade II Patient with mild systemic disease
  • Grade III Patient with moderate systemic
    disease not incapacitating life
  • Grade IV Patient with severe systemic disease
    that is incapacitating life
  • Grade V Moribund patient who is not expecting
    to survive 24 hours with or without operation
  • Suffix E Suffix E to any grade indicates
    emergency operation

American Society of Anesthesiologists
8
Pre-Operative Preparation
  • Fasting for 4 to 6 hours to prevent vomiting and
    dangers of aspiration of gastric content
  • Premedication for sedation and to lessen anxiety
  • Correction of fluid and electrolyte balance
  • Continuation or discontinuation of maintenance
    drugs, if necessary
  • Mental preparation for the operation
  • Informed consent

9
Pre-Operative Evaluation
  • Planning for anesthesia
  • Choosing type of anesthesia
  • Choosing anesthetic drugs
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