Medical conditions that increase the risks of surgery
Bleeding disorders (thrombocytopenia, hemophilia)
increase risk for hemorrhaging during and after surgery
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.
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).
alter the excretion of anesthetic drugs and their metabolites and alters acid-base balance, increasing risk for surgical complications.
alters metabolism and elimination of drugs administered during surgery and impairs wound healing and clotting time because of alterations in protein metabolism.
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.
Regular use of pain medications can result in higher tolerance, . Increased dose of opioids are frequently necessary to achieve postoperative pain control.