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Chapter: Essential Anesthesia From Science to Practice : Clinical management : Pre operative evaluation

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Planned procedure - Anesthesia Clinical management

The planned surgical, diagnostic, or therapeutic procedure influences the anesthetic management, sometimes producing problems for which we must be prepared.

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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