ANAESTHESIA WITH CONCURRENT RESPIRATORY DISEASES MODERTOR BY- DR SUCHIT KHANDUJA DR GIAN CHAUHAN JR ANAESTHESIA. Preoperative Preparation. General assessment- This involves history, examination and investigation .
MODERTOR BY- DR SUCHIT KHANDUJA
DR GIAN CHAUHAN JR ANAESTHESIA
General assessment-This involves history, examination and investigation.
History. Ask about symptoms of wheeze
Orthopnoeaand paroxysmal nocturnal dypsnoea
Examination. Inspect for
Investigations. Leucocytosis may indicate active infection, and polycythaemia chronic hypoxaemia.
ABG should be performed in patients who are dyspnoeic with minimal exertion and the results interpreted in relation to PIO2.
Preoperative hypoxia or carbon dioxide retention indicates the possibility of postoperative respiratory failure.
May require a period of assisted ventilation on the Intensive Care Unit.
Coryza (common cold)
Independent risk factors for adverse respiratory events in children with active URIs include
Use of an ETT in a child <5 yr old.
Prematurity (<37 wk).
History of reactive airway disease.
Surgery involving the airway,
Presence of copious secretions.
And presence of nasal congestion.
Child is presenting for an emergent procedure
Children for elective procedures with suspected URI children with active URIs include
Should be able to undergo surgery …. reactive airway disease were identified as predictors of adverse respiratory events
Should be postponed for surgery…… reactive airway disease were identified as predictors of adverse respiratory events
Children with more severe symptoms—including
Their elective surgery postponed for a minimum of 4 wk or more(if bact. Infection is suspected)
History and examination
predicted and chronic respiratory failure
air) are both associated with a worse prognosis.
Treatment of infection/ exacerbation minute walk test are safe and simple to perform
Airway and ventilation
Oxygen therapy further
Pain Relief maintain
Steroid supplementation maintain
Prophylaxis of venous with the premedication.thromboembolism
Prior to surgery therapy is maximised using
Restrictive pulmonary disease patient.
Intrinsic Disease patient.
The chest physician may suggest an increase in steroid dose.
Extrinsic Disease patient.