title: Optimal perioperative medical management of the vascular surgery patient.
abstract: Perioperative medical management of patients undergoing vascular surgery can be challenging because they represent the surgical population at highest risk. β-Blockers should be continued perioperatively in patients already taking them preoperatively. Statins may be used in the perioperative period in patients who are not on statin therapy preoperatively. Institutional guidelines should be used to guide insulin replacement. Recent research suggests that measurement of troponins may provide some risk stratification in clinically stable patients following vascular surgery. Multimodal pain therapy including nonopioid strategies is necessary to improve the efficacy of pain relief and decrease the risk of side effects and complications.
authors.affiliation: Department of Anesthesiology, Allegheny Health Network, Temple University School of Medicine, 2570 Haymaker Road, Pittsburgh, PA 15146, USA. Electronic address: ssingh@wpahs.org.
authors.forename: Saket
authors.initials: S
authors.lastname: Singh
authors.affiliation: Department of Anesthesiology, Allegheny Health Network, Temple University School of Medicine, 2570 Haymaker Road, Pittsburgh, PA 15146, USA.
authors.forename: Yasdet
authors.initials: Y
authors.lastname: Maldonado
authors.affiliation: Department of Anesthesiology, Allegheny Health Network, Temple University School of Medicine, 2570 Haymaker Road, Pittsburgh, PA 15146, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Taylor
mesh_terms: D000758:Anesthesia / Q000009:adverse effects / Q000379:methods; D001786:Blood Glucose / Q000378:metabolism; D016894:Endarterectomy, Carotid / Q000009:adverse effects / Q000379:methods; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control; D014652:Vascular Diseases / Q000188:drug therapy* / Q000601:surgery*; D014656:Vascular Surgical Procedures / Q000009:adverse effects / Q000379:methods*
chemical_list: D001786:Blood Glucose; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Abdominal aortic aneurysm; Anesthesia; Carotid stenosis; Cerebral hyperperfusion; Glucose control; Troponin leak; Vascular surgery; β-blocker