Pre-operative Assessment Quiz

Pre-operative Assessment

• Pre-operative assessments are conducted to identify potential patient complications during surgery and post-surgery periods.
• The assessment includes identifying existing and past medical problems, previous anesthesia experiences, family history of anesthesia complications, drug allergies, current medications, alcohol and tobacco use, review of systems (including snoring and fatigue), and exercise tolerance.
• Key aspects of the medical history include diabetes, hypertension, COPD, coronary artery disease, and thyroid disorders.
• History of previous surgeries, including dates, should be recorded, and details about family anesthetic history, particularly any anesthetic problems in the family.
• Assess potential anesthetic complications like pseudocholinesterase deficiency and malignant hyperthermia.
• Record previous experiences with anesthesia such as drug allergies, post-operative nausea and vomiting (PONV), anesthesia awareness, difficult intubation, and delayed emergence.

Physical Examination

• The physical examination focuses on the airway, particularly in patients with hypothyroidism, acromegaly, or obesity.
• Examine the mandible and maxilla for any abnormalities like micrognathia, receding mandible, or protruding maxilla.
• Facial features like beard or facial trauma should be recorded.

Premedication

• Premedication is essential for patient comfort and facilitating surgical procedures.
• The main premedication group used is opioid analgesics, which include morphine, pethidine, and fentanyl.
• Opioid analgesics are administered parenterally, produce sedation, and help control elevated blood pressure during endotracheal intubation.
• Fentanyl is preferred due to its rapid onset and short duration of action.

Fentanyl

• Fentanyl is a potent analgesic, 100 times more potent than morphine.
• Metabolized in the liver and excreted in the urine.
• Fentanyl can cause respiratory depression, requiring caution with COPD patients.
• Fentanyl causes less nausea and vomiting compared to other opioids.
• Naloxone is used to reverse the effects of fentanyl.
• The recommended dosage of Fentanyl is 1-5 micrograms per kilogram intravenously.

Anti-autonomic Drugs

• Anti-autonomic drugs are used to manage autonomic nervous system activity and include anticholinergics and beta-blockers.
• Atropine is an anticholinergic drug used in premedication, known for its vagal inhibition (causing tachycardia), CNS stimulation, and anti-sialagogue properties (reducing salivation).

Test your understanding of pre-operative assessments and their importance in identifying potential complications during and after surgery. This quiz covers essential medical history factors, anesthesia experiences, and potential risks to ensure patient safety. Evaluate your knowledge on various medical conditions and their implications for anesthesia.