Anaesthesia is the technique of using medication to prevent the sensation of pain during surgeries and other medical procedures. Local or general anaesthesia might be provided to the patient depending on the medical procedure. In the case of high-risk surgical patients, anaesthesia procedures might be complicated. 

In an interview with HT Lifestyle, Dr Bhagyashree Arbhi, HOD, Anaesthesia, Jupiter Hospital, Pune, said, “Administering anaesthesia to high-risk surgical patients is a delicate task that requires careful planning and following specific protocols to ensure patient safety.” The expert further noted down the things one must remember before administering anaesthesia to a high-risk surgical patient:

Thorough preoperative assessment:

A thorough preoperative assessment gathers detailed information about the patient’s previous medical history, current medications, physical status, and previous experiences with anaesthesia. Special attention should be paid to vital organs like the brain, heart, lungs, kidneys, and liver.

Risk assessment tools:

Risk assessment tools, such as ASA classification, along with advanced radiological and blood investigation, help determine a patient's level of risk and plan accordingly.

Constant monitoring:

In the case of high-risk surgical patients, general anaesthesia is most recommended. Close monitoring of a patient's heart rate, blood pressure, ECG, oxygen levels, and depth of anaesthesia during surgery is essential. Advance hemodynamic monitoring devices are available for continuous monitoring to ensure patient safety. Timely management of blood loss ensures hemodynamic stability. If blood pressure or heart rate is unstable, protocol-based treatment using supportive medication along with vigilant monitoring is mandatory.

Monitoring patient’s body temperature:

Monitoring the patient’s body temperature helps in keeping the patient warm – this further helps prevent complications and speeds up recovery.

Pain control:

Sometimes regional anaesthesia, such as spinal, epidural or USG-guided regional nerve blocks, can be safer than general anaesthesia because it tends to give the patient better hemodynamic stability in addition to better postoperative pain control and reduced opioid requirement.

Postoperative evaluation:

This is extremely essential as high-risk patients should be closely monitored in the intensive care unit to ensure stable vital signs, adequate hydration, and pain management.

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