Perioperative management of the patient with liver disease and management of the chronic alcoholic.
Each year millions of Americans undergo surgical procedures requiring local, general, or spinal epidural anesthesia. A disproportionate number of the patients are older than age 65, and up to 10% of the patients have end-stage liver disease. Most patients do not suffer complications as a result of the surgical procedure or the anesthetic. However, about 3% to 10% of patients experience significant morbidity, often caused by infections or cardiac or pulmonary complications. Patients who have serious liver disease are generally believed to be at increased risk for perioperative morbidity and mortality. Appropriate preoperative evaluation is the cornerstone of successful intra- and postoperative management of the effects of anesthesia and surgery and is necessary for combating complications that may result from preexisting liver disease.
Clarkson
Earl
E
Oral & Maxillofacial Surgery, The Brooklyn Hospital Center, 121 DeKalb Avenue, Brooklyn, NY 11201, USA. eicddsoms@yahoo.com
Raj Bhatia
Sanjeev
S