Common Perioperative Problems and the Anaesthetist

1 Preoperative Assessment.- 1.1 - Clinical preoperative assessment.- 1.2 - ASA — physical status classification.- 1.3 - Indications for immediate operation.- 2 Cardiovascular Disease and Anaesthesia.- 2.1 - Cardiovascular effects of anaesthesia & surgery.- 2.2 - Vasoactive and cardioactive drugs.- 2.3 - Clinical assessment of cardiovascular disease.- 2.4 - NYHA classification of cardiac functional disability.- 2.5 - Cardiac Operative Risk Index Score.- 2.6 - Hypertension.- 2.7 - Hypotension.- 2.8 - Heart failure.- 2.9 - Myocardial ischaemia.- 2.10 - Myocardial infarction.- 2.11 - Anticoagulant therapy in cardiac patients.- 2.12 - Subacute bacterial endocarditis prophylaxis.- 2.13 - Disorders of the cardiac valves and shunting.- 2.14 - Mitral stenosis.- 2.15 - Mitral regurgitation.- 2.16 - Mitral valve prolapse.- 2.17 - Aortic stenosis.- 2.18 - Aortic regurgitation.- 2.19 - Intracardiac shunting.- 3 Cardiac Arrhythmias.- 3.1 - Cardiac arrhythmias — general.- 3.2 - Antiarrhythmic drugs.- 3.3 - Specific cardiac arrhythmias.- 3.4 - Pacemakers.- 4 Respiratory Disease and Anaesthesia.- 4.1 - Blood gases — arterial and venous.- 4.2 - Calculation of expected PaO2.- 4.3 - Oxygen content and oxygen flux.- 4.4 - Respiratory function tests.- 4.5 - Pulmonary effects of anaesthesia and surgery.- 4.6 - Preoperative assessment of respiratory function & its consequences.- 4.7 - Upper respiratory tract infections and anaesthesia.- 4.8 - Pulmonary infections and anaesthesia.- 4.9 - Chronic obstructive airways disease.- 4.10- Upper airway obstruction.- 4.11 - Primary lung tumors.- 4.12 - Smoking.- 5 Haematological Problems and Anaesthesia.- 5.1 - Anaemia.- 5.2 - Sickle cell anaemia.- 6 Haemostatic Dysfunction.- 6.1 - Normal haemostasis.- 6.2 - Simple tests of haemostatic function.-6.3 - Minimally acceptable perioperative haemostatic parameters.- 6.4 - Perioperative management of coagulation factor deficiencies.- 6.5 - Perioperative management of platelet disorders.- 6.6 - Anticoagulant drugs & surgery.- 6.7 - Drugs affecting haemostasis.- 6.8 - Assessment of haemostatic disorders.- 6.9 - Anaesthesia & surgery of patients with known haemostatic disorders.- 6.10 - Intraoperative haemostatic disorders.- 7 Endocrine Disorders.- 7.1 - Diabetes mellitus.- 7.2 - Hyperthyroidism and “thyroid storm”.- 7.3 - Hypothyroidism.- 7.4 - Hyperadrenocorticism.- 7.5 - Hypoadrenocorticism.- 8 Neurological Disorders.- 8.1 - Cerebral function & abnormal physiology.- 8.2 - Classification of level of consciousness.- 8.3 - Raised intracranial pressure.- 8.4 - Head injury.- 8.5 - Disorders affecting neuromuscular function.- 8.6 - Baroreceptor reflexes & anaesthesia.- 9 Renal Dysfunction.- 9.1 - Assessment of renal function.- 9.2 - Effects of anaesthesia and surgery on renal function.- 9.3 - Threatened renal failure.- 9.4 - Renal failure.- 10 Hepatic Dysfunction.- 10.1 - Assessment of liver function.- 10.2 - Effects of anaesthesia and surgery on the liver.- 10.3 - Impaired liver function.- 11 Gastrointestinal Function.- 11.1 - The preoperative fast.- 11.2 - Effects of surgery & anaesthesia on gastrointestinal function.- 11.3 - Nausea and emesis.- 12 Electrolyte Disorders.- 12.1 - Hyponatremia & hypo-osmolality.- 12.2 - Hypernatremia & hyperosmolality.- 12.3 - Hypokalemia.- 12.4 - Hyperkalemia.- 12.5 - Hypocalcaemia.- 12.6 - Hypercalcemia.- 13 Disorders of Acid-Base Balance.- 13.1 - Definitions & diagnosis of acid-base disorders.- 13.2 - Factors modifying clinical manifestations of acid-base disorders.- 13.3 - Clinical acid-base disorders.- 14 Perioperative Fluid &Transfusion Therapy.- 14.1 - Normal fluid and electrolyte distribution.- 14.2 - Properties of intravenous fluids.- 14.3 - Principles of fluid therapy.- 14.4 - Hypovolemia.- 14.5 - Haemorrhage and blood transfusion.- 14.6 - Perioperative fluid therapy.- 15 Pharmacokinetics.- 15.1 - Pharmacokinetic principles.- 15.2 - Factors modifying drug kinetics.- Appendix - A.- Anaesthetic drug kinetic, dynamic & metabolic parameters.- Appendix - B.- Kinetic parameters of cardiovascular stimulant drugs.- Appendix - C.- Abbreviations.- Appendix - D.- Conversion factors.