Post-op care Flashcards
(18 cards)
principles of enhanced recovery
- good preparation for surgery e.g. healthy diet + exercise
- minimally invasive surgery
- adequate analgesia
- good nutritional support
- early return to oral diet + fluid intake
- early mobilisation
- avoid drains + NG tubes where possible
- early discharge
why is analgesia important in post op period?
- mobilisation
- ventilate lungs fully > reduce risk of chest infection + atelectasis
- adequate oral intake
Contraindications of NSAIDs
- asthma
- renal impairment
- peptic ulcers
- heart disease
risk factors of post op N+V
- female
- history of motion sickness or PONV
- non smoker
- use of post-op opiates
- younger age
- use of volatile anaesthetics
common options of prophylactic antiemetics
- ondansetron
- dexamethasone
- cyclizine
Whp should ondansetron be avoided in?
risk of prolonged QT interval
who should dexamethasone be used with caution in?
diabetics
immunocompromised patients
who should cyclizine be used in caution in?
heart failure
eldery patients
examples of rescue antiemetics used for post op N+V
- ondansetron
- prochlorperazine
- cyclizine
- metoclopramide
who should prochlorperazine be avoided in?
Parkinson’s disease
when should metoclopramide be avoided?
GI obstruction or perforation
options for enteral feeding
mouth
NG tube
percutaneous endoscopic gastrostomy PEG
How is total parenteral nutrition normally given and why?
via a central line to reduce risk of thrombophlebitis
What is wound dehiscence?
separation of surgical wound
Most likely cause of isolated fever 24 hours post surgery
Physiological systemic inflammatory reaction
When can COCP be restarted after surgery?
2 weeks
When can warfarin be restarted after surgery?
At usual dose on evening after surgery or next day
When can DOACs be restarted after surgery?
- 6-12 hours post op for minor procedures with low bleeding risk
- 48hours for high risk surgery or high bleeding risk
