Preparation for Surgery Flashcards
(20 cards)
when can patients drink fluids until?
2 hours before their operation
when should patients fast from?
6 hours before surgery
what are the potential complications of poorly managed diabetes during surgery?
- increased risk of wound and respiratory infections
- increased risk of post-operative acute kidney injury
- increased length of hospital stay
how is a patients on insulin with HbA1c <69 mmol/mol managed pre-operatively for minor procedures?
adjustment of their usual insulin regimen
how are diabetic patients managed in long surgeries (miss meals/dose)?
variable rate IV insulin infusion (VRIII)
how are poorly controlled diabetic patients managed preoperatively?
variable rate IV insulin infusion (VRIII)
how is metformin managed preoperatively?
day prior = normal
morning operation = normal
afternoon operation = normal
how are sulponylureas managed preoperatively?
day prior = normal
morning operation = omit
afternoon operation = omit
how are DPP IV inhibitors (-gliptins) managed preoperatively?
day prior = normal
morning operation = normal
afternoon operation = normal
how are GLP-1 analogues (-tides) managed preoperatively?
day prior = normal
morning operation = normal
afternoon operation = normal
how are SGLT-2 inhibitors (-flozins) managed preoperatively?
day prior = normal
morning operation = normal
afternoon operation = normal
how are once daily insulins managed preoperatively?
day prior = reduce dose by 20%
morning operation = reduce dose by 20%
afternoon operation = reduce dose by 20%
how are long-acting insulins managed preoperatively?
day prior = normal
morning operation = halve morning dose
afternoon operation = halve morning dose
what needs to be checked prior to thyroid surgery?
vocal cord check
what needs to be checked prior to parathyroid surgery?
methylene blue to identify gland
what needs to be checked prior to sentinel node biopsy?
radioactive marker/patent blue dye
what needs to be checked prior to surgery involving the thoracic duct?
administration of cream
what needs to be checked prior to pheochromocytoma surgery?
alpha and beta blockade
what needs to be checked prior to carcinoid tumour surgery?
covering with octreotide
what needs to be checked prior to colorectal cases?
bowel preparation
