Preoperative Evaluation and Preparation

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Questions and Answers

What is the purpose of organizing preoperative care and the operating list?

To increase the number of surgeries performed

To reduce the cost of surgeries

To schedule surgeries more efficiently

To ensure patient safety and optimize their condition (correct)

What is an important aspect of preoperative assessment related to the patient's airway?

Neurological examination

Eyesight evaluation

Cardiac function assessment

Mentothyroid distance measurement (correct)

What is the significance of a Modified Mallampati classification in preoperative assessment?

To evaluate the patient's airway (correct)

To assess liver function

To evaluate renal function

To measure blood sugar level

Why is it important to evaluate the patient's history of difficult intubation?

To prepare for potential airway challenges during anesthesia Signup and view all the answers

What is the normal Mentosternum distance in adults?

15 cm Signup and view all the answers

What is the purpose of routine investigations like CBC, Urine analysis, and X-ray chest in preoperative evaluation?

To evaluate the patient's overall health status Signup and view all the answers

What is the recommended interval of NPO (nil per os) for solid diet before surgery in children?

6-8 hours Signup and view all the answers

In what condition should elective surgery be delayed for a patient with a diastolic blood pressure (DBP) ≥ 110 mmHg?

With signs of end organ damage Signup and view all the answers

What is the role of β-adrenergic blockers (e.g., atenolol, propanolol) in perioperative care?

Decrease sympathetic response Signup and view all the answers

When should aspirin be discontinued before elective surgery?

One week before Signup and view all the answers

What is the recommended interval of NPO for clear liquid diet before surgery in children?

2 hours Signup and view all the answers

In which scenario is elective non-cardiac surgery more likely to be postponed post myocardial infarction (MI)?

Reinfarction is more likely within 3-6 months Signup and view all the answers

What is the recommended duration for smoking cessation before elective surgery to decrease postoperative pulmonary complications?

$4-8$ weeks Signup and view all the answers

For high risk patients, what form of DVT prophylaxis is indicated before surgery?

Pneumatic stockings Signup and view all the answers

Which antihypertensive medications are usually continued before surgery?

Calcium channel blockers Signup and view all the answers

Study Notes

Purpose of Preoperative Care Organization

Ensures patient safety and optimal outcomes by systematically preparing a patient for surgery.
Facilitates efficient scheduling of surgeries and management of operating room resources.

Preoperative Assessment and Airway

An important aspect of preoperative assessment is evaluating the patient's airway to anticipate potential difficulties in intubation.
Identifying risks related to airway management is critical for planning interventions.

Modified Mallampati Classification

A scoring system used to predict the ease of intubation based on the visibility of oropharyngeal structures.
Higher classifications indicate potentially more challenging airway management.

History of Difficult Intubation

Evaluating a patient’s history of difficult intubation is crucial to prepare for potential complications during anesthesia.
Past intubation challenges can dictate the choice of anesthetic technique and equipment.

Normal Mentosternum Distance

The normal mentosternum distance in adults is approximately 12-13 cm.
This measurement helps assess the potential for intubation success.

Routine Investigations Purpose

Routine investigations like CBC, urine analysis, and chest X-ray are essential for identifying underlying health issues.
They provide baseline data crucial for perioperative planning and management.

NPO Intervals for Children

For solid food, the recommended NPO (nil per os) interval before surgery in children is at least 6 hours.
For clear liquids, the interval is generally 2 hours before surgery.

Diastolic Blood Pressure and Elective Surgery

Elective surgery should be delayed if a patient has a diastolic blood pressure (DBP) ≥ 110 mmHg due to increased cardiovascular risks.

Role of β-Adrenergic Blockers

β-adrenergic blockers like atenolol and propranolol help manage heart rate and reduce cardiovascular complications during surgery.
They may be initiated or continued for patients with underlying cardiovascular conditions.

Aspirin Discontinuation Before Surgery

Aspirin should typically be discontinued at least 5-7 days prior to elective surgery to reduce the risk of excessive bleeding.

NPO for Clear Liquid Diet

The recommended NPO interval for clear liquid diet before surgery in children is at least 2 hours.

Elective Surgery Post Myocardial Infarction

Elective non-cardiac surgery is often postponed for at least 6 months following a myocardial infarction to reduce cardiac risks.

Smoking Cessation Before Surgery

A minimum of 4-6 weeks of smoking cessation is recommended before elective surgery to lower postoperative pulmonary complications.

DVT Prophylaxis for High-Risk Patients

For high-risk patients, mechanical or pharmacologic DVT (Deep Vein Thrombosis) prophylaxis is indicated before surgery to prevent thromboembolic events.

Continuation of Antihypertensive Medications

Most antihypertensive medications, such as ACE inhibitors and beta-blockers, are usually continued up to the day of surgery to maintain hemodynamic stability.

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Description

This quiz covers the importance of organizing preoperative care, assessing surgical, medical, and anesthetic aspects, optimizing the patient's condition, and obtaining consent. It also includes specific questions for history and examination, such as past surgery history, medication, and allergies.