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COPD, ASTHMA
Site of incision
Type of anaesthesia
CLINICAL ENTITIES:
Cigarette consumption
Medical therapy
Dyspnoea
ROIZEN’S CLASSIFICATION OF DYSPNOEA
Wheeze? Crepitations?
Associated conditions
Nutritional status
Hydration status
INVESTIGATIONS:
Hematocrit
Total and differential count
ECG
Chest X ray
Echocardiography
ABGs
PFTs
PREOP OPTIMIZATION
Stop smoking
Treat infection
physiotherapy (chest)
Drug therapy
PREMEDICATION AND ADVICE:
Atropine ?
BZD?
H2 blockers?
H1 blockers: Diphenhydramine
Bring inhaler to OT
CONDUCT OF ANAESTHESIA
RA where feasable
GA:
Analgesia: pethedine, fentanyl
Aminophylline
hydrocortisone
POST OPERATIVE:
Early mobilization and posture
Oxygen
Fluid balance