Perioperative Medicine

Mr Jones, a 78 year old male is on the day of surgery unit waiting for his laparoscopic inguinal hernia repair. He is known to have stage 1 hypertension and is on amlodipine, which he took this morning. His blood pressure on admission is 201/94. At Preop Assessment his BP is documented as 154/88What do you do?

Recheck. If still elevated, cancel the case

Give him some benzodiazepine, recheck and proceed if BP has come down

Give him another dose of antihypertensive and re-order the list, proceed if BP has come down

Crack on

Bring him to the anaesthetic room and give him some propofol and fentanyl. If BP doesn't improve, send back to the ward and cancel

Ask the named consultant to help decide

Mrs Smith is on an ACE inhibitor for her hypertension. What are we advising her to do with regards to stopping her medication preoperatively?

24 hours

48 hours

No change

Not sure

You are anaesthetising a patient for a laparoscopic hemicolectomy and your usual practice is a spinal and GA. The patient has atrial fibrillation and is usually anticoagulated on rivaroxaban. His last dose was 48 hours ago. Are you happy to proceed?

Yes

Need more information

A 48 year old female is on your list for a laparoscopic cholecystectomy. Her BMI is 48. She has fibromyalgia but no other comorbidities. Her STOP BANG was 2. She is listed as a day case. Are you happy to proceed?

Yes

Perioperative Medicine

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