Medical conditions that increase the risks of surgery

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Bleeding disorders (thrombocytopenia, hemophilia)

increase risk for hemorrhaging during and after surgery

Diabetus mellitus

increase susceptibility to infection and impairs wound healing from altered glucose metabolism and associated circulatory impairment

Fluctuating blood glucose levels cause central nervous system alterations during anesthesia. Stress of surgery causes increases in blood glucose level.

Heart disease (recent myocardial infarction, dysrhythmias, congestive heart failure) and peripheral vascular disease

Stress of surgery causes increased demands on myocardium to maintain cardiac output. General anesthetic agents depress cardiac function.

Hypertension

increases risk for respiratory complications during anesthesia (e.g. stroke, inadequate tissue oxygenation).

upper respiratory infection

increases risk for respiratory complications during anesthesia (eg. pneumonia, spasms of laryngeal muscles).

renal disease

alter the excretion of anesthetic drugs and their metabolites and alters acid-base balance, increasing risk for surgical complications.

liver disease

alters metabolism and elimination of drugs administered during surgery and impairs wound healing and clotting time because of alterations in protein metabolism.

fever

predisposes patient to fluid and electrolyte imbalances and often indicates underlying infection

chronic respiratory disease (emphysema, bronchitis, asthma)

reduces patient's means to compensate for acid-base alterations. Anesthetic agents reduce respiratory function, increasing risk for severe hypoventilation.

Immunological disorders (leukemia, acquired immunodeficiency syndrome, bone marrow depression, organ transplantation, and use of chemotherapeutic drugs)

increases risk for infection and delay wound healing after surgery

Abuse of alcohol and street drugs

Alcohol addiction causes unpredictable reactions to anesthesia. persons go into withdrawal during and after surgery.

Chronic pain

Regular use of pain medications can result in higher tolerance, . Increased dose of opioids are frequently necessary to achieve postoperative pain control.

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