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## 2.3 HISTORY AND EXAMINATION OF THE SURGICAL PATIENT **Important Points From The History: (Not limited to)** * Previous illness * Pneumonia or asthmatic attacks, cough or breathlessness suggestive of cardiopulmonary diseases * Frequency, nocturia, and polydipsia suggestive of genitor-r...

## 2.3 HISTORY AND EXAMINATION OF THE SURGICAL PATIENT **Important Points From The History: (Not limited to)** * Previous illness * Pneumonia or asthmatic attacks, cough or breathlessness suggestive of cardiopulmonary diseases * Frequency, nocturia, and polydipsia suggestive of genitor-renal diseases and diabetes mellitus (DEARTH) **Previous operation and anaesthetic experience** * Complications may be avoided this time, such as drug hypersensitivity or allergic reactions. **Concurrent diseases which may affect the conduct of anaesthesia** * Diabetes * Chest infections * Heart diseases * Myopathies **Drug Therapy** * Drug interactions with anaesthetic agents may affect the patient's ability to maintain homeostasis. * Long term steroid therapy suppresses the patient's adrenocortical function and makes the glucocorticoid response to surgery inadequate. It depresses lymphocyte and B cell functions and reduces interleukins synthesis. The patient becomes more susceptible to infection and wound healing is also slow. * Women on OCPs are at moderate risk for deep vein thromboses and these should be stopped for about 6 weeks before elective surgery. * Cytotoxic and radiation therapies impair immune functions and wound healing; symptoms and signs of infection may be absent. * Broad-spectrum antibiotics cover during surgery in such patients is therefore essential. * Aspirin or other antiplatelet drugs should be stopped 7 days prior to elective surgery. **Social Habits** * Alcohol abuse may necessitate increased requirement of anaesthesia. Alcohol may also impair liver function and nutrition. It is a direct bone marrow toxin. Alcoholics have two to three fold increase in postoperative morbidity.