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Blockers, calcium channel blockers, and clonidine may be continued in the perioperative period. B. Coronary Artery Disease. A patient with known CAD (history of previous coronary artery bypass grafting or stents, previous MI, or angina with ischemia evidenced on stress testing) or one at risk for CAD may benefit from premedication with β-blockers. , 2006) suggests the routine use of perioperative β-blockade (previously believed to decrease perioperative mortality) may actually be harmful. However, a patient on chronic β-blocker therapy should continue his or her medication through the day of surgery to avoid withdrawal effects.
Insulin and hypoglycemics) medications. The decision to continue medication during the preoperative period depends on the severity of the underlying illness, the potential consequences of discontinuing treatment, the half-life of the medication, and the likelihood of deleterious interactions with proposed anesthetic agents. As a general rule, most medications may be continued up through the time of surgery (see section VI). C. Allergies and Drug Reactions. True allergic reactions are relatively uncommon.
Respiratory. 1. Upper respiratory infection. Upper respiratory infection (URI), especially in children, can predispose patients to pulmonary complications including bronchospasm and laryngospasm during induction and emergence from general anesthesia. , productive cough, rhinorrhea, sore throat, fever) may benefit from postponement of an elective procedure. 2. Asthma. Reactive airway disease may result in acute bronchospasm in the perioperative period. Specific questions about previous asthma-related hospitalizations, intubations, emergency room visits, and medication requirement (specifically, steroid use) can help delineate the severity of asthma.