A 52-year-old woman who has been bleeding per rectum presents for an elective hemicolectomy on the following day’s list. Her blood pressure is 180/120 mmHg on the ward, and she is a member of a hill walking club. She has not seen a doctor for the past 30 years.
- How would you approach this case? Describe your preoperative assessment. - What would you do about the patient’s high blood pressure reading? - What are the causes of hypertension? - What complications might arise in a hypertensive patient as a result of anaesthesia? - Would you have concerns over the patient’s history of bleeding per rectum? - How would you weigh up the urgency of surgery and the hypertension risk? - How would you anaesthetise her? - What postoperative pain relief would you administer?
ArticleDate:20080410
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