Thyroid Disease
Degree of thyroid dysfunction Laboratory findings Elective Urgent/emergent Treatment Subclinical ■ Increased TSH ■ Normal free T4 ■ Proceed ■ Proceed ■ None Mild–moderate ■ Increased TSH ■ Low free…
Perioperative Beta-Blockers
© Springer International Publishing Switzerland 2015Molly Blackley Jackson, Somnath Mookherjee and Nason P. Hamlin (eds.)The Perioperative Medicine Consult Handbook10.1007/978-3-319-09366-6_8 8. Perioperative Beta-Blockers Paul B. Cornia1 and Kay M. Johnson1 (1) Division of General Internal Medicine, Department of Medicine, University of…
The Preoperative Evaluation
Requesting physician Usually the surgeon, sometimes a PCP or specialist, or anesthesiologist Consult for Specific reason for or question for consultation Chief complaint Include the intended surgical procedure Date of…
Perioperative Medication Management
Drugs to hold for at least 2 weeks preoperatively Aspirin: Hold for a minimum of 1 week; consider 2 weeks for neuro/spine surgery Warning: Must evaluate whether patient has received…
Atrial Fibrillation
Rate control If NPO Individualize desired rate control target, depending on the patient’s baseline rate control goals, the presence of ischemic heart disease, and the patient’s post-op blood pressure. In…
Stress-Dose Steroids
HPA axis status Glucocorticoid (GC) exposure Management NOT suppressed <3 weeks Every-other-day therapy AM dose of <5 mg prednisone or equivalenta Take usual AM dose of GC MAY be suppressed…
Hypertension
Beta-blockers Continue, and take on the morning of surgery ACE inhibitors Hold on the morning of surgery unless patient has poorly controlled HTN at baseline, e.g., SBP > 180 or DBP > 110 ARBs…
Introduction
Avoid recommendations on these subjects Type of anesthesia; invasive intraoperative monitoring such as pulmonary artery (PA) catheters or transesophageal echocardiography (TEE) These decisions are best left to the anesthesiologist Per…
Diabetes Mellitus
BASAL insulin Longer-acting insulins (e.g., glargine, detemir, and NPH) which provide a constant supply of “background” insulin, regardless of meals. All patients with type 1 diabetes require this and many…
Anesthesia Pearls
© Springer International Publishing Switzerland 2015Molly Blackley Jackson, Somnath Mookherjee and Nason P. Hamlin (eds.)The Perioperative Medicine Consult Handbook10.1007/978-3-319-09366-6_5 5. Anesthesia Pearls Gail A. Van Norman1 (1) Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA…
