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Preoperative Care

“The most important decision a surgeon can

make is to operate on a patient” 

The decision is a Risk-Benefit  Analysis

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Goals(Why)

Recognize and Optimize the risk factors for

surgery

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How to do it

History

Examination

nvestigations

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History Taking

!ast medical " surgical history #ardiac$ respiratory$ renal$ nutrition

Drug hx

Social Hx %unctional status

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 ASA Classifcation

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Investigations

&asics 'for all age()*+ %&#$ urea,electrolyte

#-.$ E#/

Specific '0hen indicated+

L%12 !1,!11

 3&/2 !ulmonary function test

others

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Special Preparation

Management of Dia4etes

D51 !rophylaxis

&o0el preparation

!rophylactic anti4iotics selectively

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Postoperative Care

.ecogni6e postop complications

!ain management

!ostop fevers

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Postop Coplications

General mportant examples7

 3M

pneumonia,atelectasis renal failure

D51,!ulmonary em4olism

#53

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Postop Coplications

Specific Examples7

anastomotic leakage

a4scess formation 0ound infection

 ileus

 4leeding

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Scenario

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Pain !anageent

Essential part of postop management

!ain can increase risk of complications

!ain relief8 Multimodal E9g9 !#3$ M pethidine$ oral analgesics

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Postop "evers

 3n important sign of postop complications

Many possi4le DD-

1ime of onset may guide the management

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Postop "evers

%irst :;hrs Atelectasis

1ransfusion rxn

!re8existing infection

<8= days7 infections U1$ 0ound infection$ pneumonia$ anastomotic

leakage

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Postop "evers

 34out = days on0ards nfections

 34scess formation

DVT/PE

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Postop "evers

History

Examination

nvestigations 'to confirm the diagnosis+

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S#ary

!re and !ostop care are essential parts of

surgical treatment

/ood History$ physical examination and

selected investigations are the key

#omplications do occur$ 4ut many are

preventa4le>

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$#estions