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Retrospective study of perioperative management of cardiac patients for noncardiac surgery

Authors:Dr. Sandhya Gujar, Dr. Swati Adivarekar Dr. Tejas Bhandari, Dr. Swapnil Khadake, Dr. Kruti Mehta
Int J Biol Med Res. 2016; 7(2): 5510-5514  |  PDF File

Abstract

Introduction: Successful perioperative management of patient with cardiac disease for elective noncardiac surgery requires multidisciplinary action. Most important is stratification and classification of patients to understand risk involved, optimization of patients with preoperative investigations and medications in order to reduce the risk of morbidity and mortality associated with major surgery. Methods and Materials:Hundred patients with cardiac disease were divided into 3 groups, Group A – Patients with only ECG changes, Group B – Patients with ischemic heart disease and Group C – Patients with valvular heart disease. These patients were studied for preoperative investigations required, time required for optimization, choice of anaesthesia plan and suitable technique used along with required monitoring and complications were treated.Results:Patients who were classified as ASA grade III and IV were having more risk involved for perioperative complications, especially patients who were given combined spinal epidural anaesthesia and general anaesthesia. Conclusion:Planning anaesthesia for cardiac patients undergoing non-cardiac surgery helps in decreasing morbidity associated in perioperative period by giving only epidural anaesthesia or supplementing epidural with general anaesthesia helps in maintaining vital parameters by preventing pain and its associated detrimental effects