2005, June; 1: 27-31
Rabiul et al
Pre-anaesthetic incidental detection of systemic diseases
PRE-ANAESTHETIC INCIDENTAL DETECTION OFSYSTEMIC DISEASES
Rabiul M Alam
, Mahbubul M Alam
, Zahurul M Islam
Pre-anaesthetic assessment provides the
preoperative physical status, existingmedical conditions and their severity. Peri-operative morbidity and mortality are reduced by pre-anaesthetic optimisation of the patients. This prospective study was aimed to find out theincidence of detection of the pre-existing systemic diseases which were not diagnosed earlier.
A total of 2,086 indoor patients were studied during pre-anaesthetic assessment whowere from all age-groups and of both sexes requiring routine surgical procedures under any typeof anaesthesia. Check-up was carried out basing on history, physical examinations andinvestigation reports. The numbers of incidentally detected diseases were tabulated, analysedand compared with that of those pre-existing diseases, prevailed in the population.
The major incidental findings of diseases were: conduction heart block [18.75%], chronicobstructive pulmonary disease (COPD) [15%], anaemia [11.62%], ischaemic heart disease (IHD)[5.55%], and some other conditions like bronchial asthma, systemic hypertension, peptic ulcerdisease (PUD) and drug allergy. The findings were statistically significant (
<0.05) in respectof conduction defects, COPD, anaemia, IHD, PUD and drug allergy.
The findings revealed a possibility of increased peri-operative morbidity andmortality if meticulous and proper attention was not given while preparing the patients foranaesthetic procedures. Thus it was concluded that every hospital must run an effectiveanaesthesia out-patient department with the capability of careful and efficient check-up system todetect the undiagnosed diseases during pre-anaesthetic assessment for safe anaesthesia.
pre-anaesthetic assessment, P/A checkup, incidental detection, systemic disease.
Surgical mortality and morbidity arenot only the consequences
of the surgical
procedure itself, but also of the patient’s
preoperative physical status. Thepreoperative anaesthetic
visit is aimedprimarily at detecting these medicalconditions
and assessing their severity.Subsequent preoperative optimization
patient’s condition reduces perioperative and
risks . Thepreoperative anaesthetic visit also serves to
guide the most appropriate anaesthetictechnique and to provide
patientinformation. Medical assessments enablephysicians to reduce morbidity by obtaininghealth status and planning peri-operativemanagement.
Department of Anaesthesia, Combined Military Hospital, Chittagong, Bangladesh.
Department of Anaesthesia, Combined Military Hospital, Dhaka, Bangladesh.
Dr. (Lt Col) Rabiul M Alam, MBBS, MCPS, FCPS; Department of Anaesthesia,Combined Military Hospital, Chittagong cantonment, Chittagong, Bangladesh.