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1.4 In the preoperative assessment clinic, what investigations would you do on a 70-year-old woman, with
controlled hypertension and COPD from smoking 20 cigarettes per day for 50 years, who is scheduled for a total
hip replacement and why?
1.5 A 43-year-old woman seen in the clinic prior to having a laparoscopic cholecystectomy is assessed as being
ASA II due to well controlled hypertension. She asks what are the risks of having a general anaesthetic? What
would you tell her?
Mild or early:
circumoral paraesthesia;
numbness of the tongue;
visual disturbances;
lightheadedness;
slurred speech;
twitching;
restlessness;
mild hypotension and bradycardia.
Severe or late:
grand mal convulsions followed by coma:
respiratory depression and eventually apnoea;
cardiovascular collapse with profound hypotension
and bradycardia;
_ cardiac arrest.
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Management of LAST
Stop giving the local anaesthetic immediately,
get help;
Maintain the airway using basic techniques.