Clinical Anaesthesia/Common Preop Medical Conditions

URTI (Upper Respiratory Tract Infection) / Common cold

Common. Take temperature and ask the patient the following: Hot and shivery? / muscle pains? (signs of systemic viraemia) Cough +/- sputum? (associated chest infection)

Viraemia carries a risk of cardiac involvement with a predisposition to perioperative cardiac arrhythmias (dysrhythmias).
Associated chest infection may worsen with either general or major regional anaesthesia (impaired cough and ciliary escalator). Elective surgery should be postponed.

Apyrexial (<37.5 °C) and no muscle pains or cough: probably OK to proceed with surgery.

Note: the prodromal period of many systemic viral illnesses is indistinguishable from the typical short-lived URTI. The patient recovering from major surgery may find this complicated by a developing viral illness.

Hypertension

Either newly discovered, or pre-existing and poorly controlled.

BP should be less than 140/90 to be fit for surgery. In emergency conditions, hypertension is not a reason to not provide anaesthesia care.

Patients are usually encouraged to take their blood pressure medications prior to the surgery. Patients are not allowed to eat or drink after midnight the day before the surgery. Patients can take their blood pressure medications with a sip of water.