A PATIENT WITH IHD AND HYPERTENSION FOR RIGHT HEMICOLECTOMY Dr. Murali.R.Chakravarthy, Chief Consultant, Fortis Hospital, Bangalore
Dr. Gangadhar.S.B Professor & HoD, Siddhartha Medical College, Tumkur
A 60 years old male is posted for right hemicolectomy for colon cancer. Patient is a known hypertensive for past 10 years. Past history also reveals post PTCA status (1 year back). Patient is on regular medication with clopidogrel, aspirin, metaprolol, isosorbide and nifedipine. O/E: PR= 60 bpm, BP=140/90 mm Hg ECG= Q waves in lead II, III, aVF & T wave inversions V5 & V6 Echo= global hypokinesia of heart with ejection fraction 38%
Points for discussion: Preoperative optimisation and perioperative management of the above patient coming for 1. elective upper abdominal surgery, 2. emergency upper abdominal surgery [Duodenal ulcer perforation] 3. DHS for fracture neck of femur
Investigations and treatment of IHD
Transfusion trigger in an IHD patient
Anesthetic implications and ACC/AHA guidelines
Postoperative pain management