Planned procedure
The
planned surgical, diagnostic, or therapeutic procedure influences the
anesthetic management, sometimes producing problems for which we must be
prepared. For example, the neurosurgeon may trigger a wild release of
cate-cholamines when destroying the trigeminal ganglion in a percutaneous
procedure that lasts only minutes. How are we going to protect the patient from
the expected sympathetic storm? Or, how can we guard against a sudden and
substantial rise in peripheral arterial resistance when the surgeon clamps the
aorta in prepar-ation for the resection of an aortic aneurysm? The planned
procedure also has implications for, among other things, intra-operative
positioning of the patient, potential need for blood replacement, anticipated
severity of post-operative pain (is a regional anesthetic an option?), and need
for intensive care after surgery.
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