General anaesthesia: Difference between revisions

Prior to a planned procedure, the anesthesiologist reviews medical records, interviews the patient, and conducts a physical examination to obtain information regarding their medical history and current physical state, and to determine an appropriate anesthetic plan, including what combination of drugs and dosages will likely be needed for the patient’spatient's comfort and safety during the procedure. A variety of non-invasive and invasive monitoring devices may be necessary to ensure a safe and effective procedure. Key factors in this evaluation are the patient's age, gender, [[body mass index]], medical and surgical history, current medications, exercise capacity, and fasting time.<ref>{{cite journal | vauthors = Lederman D, Easwar J, Feldman J, Shapiro V | title = Anesthetic considerations for lung resection: preoperative assessment, intraoperative challenges and postoperative analgesia | journal = Annals of Translational Medicine | volume = 7 | issue = 15 | pages = 356 | date = August 2019 | pmid = 31516902 | pmc = 6712248 | doi = 10.21037/atm.2019.03.67 }}</ref><ref>{{cite journal | vauthors = Izumo W, Higuchi R, Yazawa T, Uemura S, Shiihara M, Yamamoto M | title = Evaluation of preoperative risk factors for postpancreatectomy hemorrhage | journal = Langenbeck's Archives of Surgery | volume = 404 | issue = 8 | pages = 967–974 | date = December 2019 | pmid = 31650216 | pmc = 6935390 | doi = 10.1007/s00423-019-01830-w | doi-access = free }}</ref> Thorough and accurate preoperative evaluation is crucial for the effective safety of the anesthetic plan. For example, a patient who consumes significant quantities of [[Alcoholic beverage|alcohol]] or [[Recreational drug use|illicit drugs]] could be undermedicated during the procedure if they fail to disclose this fact, and this could lead to [[anesthesia awareness|anaesthesia awareness]] or intraoperative [[hypertension]].<ref>{{cite journal | vauthors = Budworth L, Prestwich A, Lawton R, Kotzé A, Kellar I | title = Preoperative Interventions for Alcohol and Other Recreational Substance Use: A Systematic Review and Meta-Analysis | journal = Frontiers in Psychology | volume = 10 | pages = 34 | date = 2019-02-04 | pmid = 30778307 | pmc = 6369879 | doi = 10.3389/fpsyg.2019.00034 | doi-access = free }}</ref><ref>{{cite journal | vauthors = Siriphuwanun V, Punjasawadwong Y, Saengyo S, Rerkasem K | title = Incidences and factors associated with perioperative cardiac arrest in trauma patients receiving anesthesia | journal = Risk Management and Healthcare Policy | volume = 11 | pages = 177–187 | date = 2018-10-18 | pmid = 30425598 | pmc = 6201994 | doi = 10.2147/rmhp.s178950 }}</ref> Commonly used medications can also interact with anaesthetics, and failure to disclose such usage can increase the risk during the operation. Inaccurate timing of last meal can also increase the risk for aspiration of food, and lead to serious complications.<ref name=":11">{{Cite book |title=Miller's anesthesia |date=2020 |publisher=Elsevier |editor=Michael A. Gropper |isbn=978-0-323-61264-7 |edition=Ninth |location=Philadelphia, PA |oclc=1124935549}}</ref>