- Stop Warfarin 5 days before surgery. May be bridged with Lovenox.
- Do not stop statin before surgery
- Do not start beta-blocker on day of surgery, but may continue
Assessment of surgical risk - ANSWER - Unstable cardiac condition
(recent MI, active angina, active HF, uncontrolled HTN, severe
valvular disease), concern with CAD, CHF. arrhythmia, CVD
- patient stable or unstable?
- urgency of the procedure (oncology will be time sensitive)
- risk of procedure
- nutritional status
- immune competence
- determine functional capacity (need to be more than 4 METS, more
than 10 METs makes low risk)
, 3
Low risk surgeries - ANSWER catarcts
, 4
breast biopsy
cystoscopy,
vasectomy
laporascopic
procedures
Plastic surgery
intermediate risk surgeries - ANSWER Head/
neck surgery thyroidectomy
Intraperito
neal
Prostate
Laminecto
my Hip/
knee
Hysterecto
my
cholecystec
tomy
nephrecto
my
non majot intrathoracic
High risk surgeries - ANSWER
aortic/ cabg transplants
spinal
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