Recognition & Management of Pre-Operative Risks

[Guest guest]

Recognition & Management of Pre-Operative Risks

Screening

About 60% of surgical patients have other medical problems especially in the

older population. Heart disease is the most common diseases in this group of

people followed closely by lung and metabolic problems. These problems are

usually diagnosed by a physical examination and a detailed history.

Laboratory tests and imaging studies can also be done to detect possible

complications.

Patients with rheumatologic diseases may be at a higher risk for

complications of surgery due to systemic changes, medications, side effects

or more specific joint related problems. When preparing a patient with a

rheumatic disease for surgery, these issues need to be carefully considered.

Rheumatoid Arthritis

Patients with a long history of RA tend to have extensive joint erosions.

Manipulation during surgery could result in injury especially when the

patient needs to have a breathing tube during a procedure. This type of

manipulation could cause spinal cord injury. Careful consideration must be

used to prevent possible problems with RA patients. Post-operatively, it is

important to continue range of motion exercises and encouragement of early

ambulation to prevent contractures in the joints. Some studies show that

patients who have joint replacements should take antibiotics before surgery

to protect against endocarditis, inflammation of one of the linings of the

heart. Patients with gout may also experience flares during the

post-operative period.

Systemic Lupus Erythematosus (SLE)

After gathering the patient's complete information through a detailed

assessment, attention is geared toward the determination of active disease.

This is done through history & physical, laboratory findings, and thorough

assessment of blood and kidney function. Special attention is paid to the

presence of anemia and other factors present in lab work. Immunosuppressive

therapy should be discontinued before surgery. Steroids should always be

continued during surgery.

Although there are risks with every surgery, modern technology allows most

patients to undergo surgery with minimal risk to the patient. The physician

can help further decrease the risks through complete assessment as described

previously.

[Guest guest]

Hi a...this article was very helpful to me. Thank you for all your

hard work here. It is much appreciated.

Hugs...

Tess

[Guest guest]

You¹re very welcome Tess.

Hugs,

a

On 5/23/02 9:47 PM, " Tess_St_Pierre@... " <Tess_St_Pierre@...>

wrote:

> Hi a...this article was very helpful to me. Thank you for all your

> hard work here. It is much appreciated.

>

> Hugs...

>

> Tess