Neurological and psychiatric disorders

Neurological and psychiatric disorders

Anticonvulsants and anti-Parkinson’s medication must be continued perioperatively to help early mobilisation of the patient, and patients should be planned early on a theatre list to reduce starvation times. Parenteral medication plans can be set in place preoperatively if there is potential for a prolonged ‘nil by mouth’ period postoperatively . Lithium should be stopped 24 hours prior to major sur gery but can be continued for minor surgery with careful fluid management and U&Es monitoring. The anaesthetist should be informed if patients are on psyc hiatric medications, such Erik Adolf von Willebrand , 1870–1949, physician, Diakonissanstaltens Hospital, Helsinki, (Helsingfors), Finland, described hereditary pseudohaemophilia in 1926. /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF as tricyclic antidepressants or monoamine oxidase inhibitors (MAOIs), as these may interact with anaesthetic drugs. Case- device by-case decisions with a psychiatrist must be undertaken as stopping irreversible MAOIs safely may take many weeks of planning under psychiatric supervision. -

Age >60 years 2 Obesity (BMI >30 kg/m ) Trauma or surgery (especially of the abdomen, pelvis and lower limbs) Total anaesthesia time >90 minutes Reduced mobility for more than 3 days Pregnancy/puerperium Varicose veins with phlebitis Drugs, e.g. oestrogen contraceptive, HRT, smoking Known active cancer or on treatment, signi /f_i cant medical comorbidities, critical care admission Family/personal history of thrombosis, e.g. de /f_i ciencies in antithrombin III, protein S or C BMI, body mass index; HRT, hormone replacement therapy.

Neurological and psychiatric disorders

Anticonvulsants and anti-Parkinson’s medication must be continued perioperatively to help early mobilisation of the patient, and patients should be planned early on a theatre list to reduce starvation times. Parenteral medication plans can be set in place preoperatively if there is potential for a prolonged ‘nil by mouth’ period postoperatively . Lithium should be stopped 24 hours prior to major sur gery but can be continued for minor surgery with careful fluid management and U&Es monitoring. The anaesthetist should be informed if patients are on psyc hiatric medications, such Erik Adolf von Willebrand , 1870–1949, physician, Diakonissanstaltens Hospital, Helsinki, (Helsingfors), Finland, described hereditary pseudohaemophilia in 1926. /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF /uni25CF as tricyclic antidepressants or monoamine oxidase inhibitors (MAOIs), as these may interact with anaesthetic drugs. Case- device by-case decisions with a psychiatrist must be undertaken as stopping irreversible MAOIs safely may take many weeks of planning under psychiatric supervision. -

Age >60 years 2 Obesity (BMI >30 kg/m ) Trauma or surgery (especially of the abdomen, pelvis and lower limbs) Total anaesthesia time >90 minutes Reduced mobility for more than 3 days Pregnancy/puerperium Varicose veins with phlebitis Drugs, e.g. oestrogen contraceptive, HRT, smoking Known active cancer or on treatment, signi /f_i cant medical comorbidities, critical care admission Family/personal history of thrombosis, e.g. de /f_i ciencies in antithrombin III, protein S or C BMI, body mass index; HRT, hormone replacement therapy.