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Chapter 11. Anesthesia

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Many patients take over-the-counter herbal remedies. In the perioperative period patients should be advised

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A. To continue taking their usual herbal remedies

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B. Stop only those remedies that have been approved by their physician

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C. Continue taking only those remedies that have been approved by the FDA

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D. Stop all over-the-counter herbal remedies

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D. Stop all over-the-counter herbal remedies. Although the use of herbal medications has been around for many years, none have been approved by the FDA. Many times the pharmacology of these remedies is unknown and the remedies may not contain the correct amounts of active ingredients stated on the label. It is estimated that up to 12% of patients are using these herbal drugs.

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Regarding the timing of the preoperative anesthesia workup for patients scheduled for a surgical procedure

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A. The initial assessment can be done the day of surgery for healthy patients undergoing procedures of high surgical invasiveness.

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B. The initial assessment should be done at a minimum the day before surgery for patients undergoing procedures of high surgical invasiveness.

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C. The preoperative assessment for healthy patients by an anesthesiologist is not required.

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D. A note from the patient’s primary care physician stating that the patient is “cleared for anesthesia and surgery” will suffice as the preoperative assessment.

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B. The initial assessment should be done at a minimum the day before surgery for patients undergoing procedures of high surgical invasiveness. The timing of the preoperative evaluation by an anesthesiologist depends primarily on the planned degree of the surgery. Even healthy patients undergoing a surgical procedure that involves a high degree of surgical invasiveness that may include the risks of a high volume of blood loss, prolonged surgical time, special positioning requirements, etc, should be seen at least a day before the planned procedure. Patients with significant comorbidities should be seen in a PAC at least the day before surgery no matter the degree of surgical invasiveness as it is necessary to ascertain the degree of control of the comorbidities.

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Regarding patients who have had a recent drug-eluting stent placed and scheduled for an elective surgical procedure with a high risk of bleeding

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A. Surgery may be performed within 4 weeks of stent placement as long as the patient continues taking aspirin and clopidogrel.

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B. Surgery may be performed within 4 weeks of stent ...

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