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[Perioperative management of chronic medication: to withhold, continue or intensify?]

Giovanna Lurati Buse1, Evelyne Bucher, Manfred D Seeberger

  • 1Departement Anästhesie, Universitätsspital Basel.

Therapeutische Umschau. Revue Therapeutique
|July 1, 2009
PubMed

Insights

Continue chronic medications until the day before surgery for optimal patient stability. Preoperative assessment should ensure existing treatments, like beta-blockers and statins, are optimized, avoiding new medication initiation.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Context:

  • Optimizing patient condition for surgery is crucial.
  • Chronic medications should be continued preoperatively.
  • Preoperative assessment evaluates existing medical treatments.

Purpose:

  • To guide the continuation and optimization of chronic medications before elective surgery.
  • To highlight the importance of assessing cardiological, diabetic, and thyroid treatments.
  • To advise against initiating new medications without a prior chronic indication.

Summary:

  • Chronic medications should generally be continued until the day before surgery.
  • Preoperative evaluation should focus on optimizing existing treatments for conditions like hypertension, diabetes, and thyroid dysfunction.
  • Discontinuation or initiation of certain medications, such as antiplatelets and anticoagulants, requires careful risk-benefit assessment.

Impact:

  • Ensures patients undergo surgery in the most stable condition.
  • Reduces perioperative complications by optimizing chronic disease management.
  • Provides a clear framework for preoperative medication management, enhancing surgical outcomes.

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