|
KMID : 0381219920240010068
|
|
Journal of RIMSK
1992 Volume.24 No. 1 p.68 ~ p.85
|
|
|
Clinical Evaluation of Preanesthetic Consultations for Patients Undergoing Elective Surgery
|
|
|
|
|
Abstract
|
|
|
We reviewed the patients whom we consulted before elective surgery concerning their preanesthetic medical problems during 58 months from October 1985 to July 1990. The patients were evaluated according to clinical departments, ages, medical
problems and
ASA classification of physical status.
@ES The results were as follows:
@EN 1) 12666 patients underwent elective surgery and 1147 patients were consulted(on a monthly average 19.8 patients). Among them 1121 patients were related to surgery(8.9% of total patients of elective surgery) and 26 patients were related to
pain
management. 691 patients were male and the rest were female. The number of preanesthetic consultation was 1694(average 1.48 cases per head).
2) the departmental distribution was urology(23.6% of patients), general surgery(22.1%), orthopedic surgery(21.8%), obstetrics and gynecology (9.2%), and so on.
3) the age distribution was 50~59 years of age (22.2% of patients), 60~69 years(19%), 40~49 years(17.1%), 30~39%(11.9%), 70~79 years(11%), 20~29 years(7.5%), under 10 years(5.5%) , over 80 years(3%), and 10~19 years(2.8%).
4) The main contents of preanesthetic consultation included cardiovascular system(25.4% of patients), respiratory system(19.4%), hepatobiliary system(14.4%), metabolism and endocrine system(13.8%), old age(6.7%), poor general condition(3.7%),
genitourinary system(3.2%), endotracheal intubation(2.5%), hematology(2.4%), central nervous system(2.2%), pain control (1.5%), psychiatric problem(1.3%), musculoskeletal system(0.7%), and gastrointestinal system(0.5%). The cardiovascular
problems
were
hypertension, dysrhythmia, ischemic heart disease, cerebrovascular disorder, valvular heart disease, and congenital heart disease. The respiratory problems were pulmonary dysfunction, pulmonary tuberculosis, chronic obstructive lung disease,
pneumonia,
URI, bronchiectasis, and pleurisy. The problems concerning hepatobiliary system were hepatic dysfunction, acute or chronic hepatitis, and cirrhosis. The genitourinary problems were renal dysfunction, renal failure, voiding difficulty, renal
stone,
infection. Hydronephrosis. The problems associated with endotracheal intubation were tracheostomy, abnormalities of cervical spines, difficult intubation, and difficulty in mouth opening. The hematological problems were anemia, thrombocytopenia,
coagulopathy, and hypereosinophilia syndrome. The problems related to central nervous system were trauma, mental aberration, paraplegia, and cerebral palsy. The psychiatric problems were chronic alcoholism, convulsion, schizophrenia, and senile
dementia. The problems concerning pain management were intractable cancer pain and postherpetic neuralgia.
5) The main medical problems in 40~59 years of age wer cardiovascular system(25.7% of patients), metabolism and endocrine system(21.1%), hepatobiliary system(16.1%), and respiratory system(14%). Those over 60 years of age were cardiovascular
system(31.3%), respiratory system (23.5%), old age (16.4%), and metabolism and endocrine system(10.8%). Those in 20~39 years of age were hepatobiliary system(32.3%), cardiovascular system(17%), respiratory system(14.3%), and metabolism and
endocrine
system(8.7%). Those under 20 years of age were respiratory system(42%), cardiovascular system(12%), and hepatobiliary system(10%). In the assessment of cardiovascular system most of the patients over 60 years of age had hypertension, dysrhythmia,
ischemic heart disease, and cerebrovascular disorder, those in 40-59 years of age had hypertension, those in 20~39 years of age had dysrhythmia, and those under 30 years of age had congenital disease. Concerning the respiratory system most of the
patients over 60 years of age had pulmonary dysfunction, chronic obstructive lung disease, and pulmonary tuberculosis, those in 40~59 and 20~39 years of age had pulmonary tuberculosis, and those under 20 years of age had URI. Concerning the
hepatobiliary system most of the patients in 20~39 years of age had hepatic dysfunction, acute and chronic hepatitis, and positive hepatitis B antigen reaction. Concerning the metabolism and endocrine system most of the patients in 40~59 vears of
age
had diabetes mellitus, thyoid disease, disease, and adrenal disease, those over 60 years of age had diabetes mellitus, those in 20~39 and under 20 years of age had thyroid disease. Most of the patients over 60 years of age had the problems
related
to
old age ad poor general condition. Concerning the genitourinary system most of the patients in 40~59 years of age had renal dysfunction and renal failure. Most of the patients in 20~39 and 40~59 years of age had the problems associated with
endotracheal
intubation such as cervical abnormality and difficult intubation, and those over 60 and under 20 years of age had the problems related to tracheostomy. Concerning the hematological problems most of the patients in 40~59 years of age had anemia,
thrombocytopenia, and coagulopathy. Concerning the problems associated with central nervous system most of the patients in 20~39 years of age had trauma and mental aberration, those in 40~59 years of age had trauma and paraplegia, and those over
60
years of age had mental aberration and paraplegia. The problems concerning the pain management were most in 40~59 years of age. Concerning the psychiatric problems most of the patients in 40~59 years of age had chronic alcoholism, schizophrenia,
and
convulsion, those over 60 years of age had chronic alcoholism and senile dementia. The problems concerning the musculoskeletal system were most under 20 years of age, and those concerning the gastrointestinal system were most in 40~59 years of
age.
6) In the assessment of patients consulted according to ASA classification class I was 2%, II was 58%, III was 38%, and IV was 2%.
|
|
|
KEYWORD
|
|
|
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|