Peri- and Intraoperative Care

Past history is important to predict possible complications during surgery. Risk factors of ischemic heart disease include diabetes mellitus, hypertension, hyperlipidemia, obesity, and smoking. Patients over 60 years of age have possibility of latent coronary artery stenosis. Monitoring during operation is indispensable. Heart rate, blood pressure, electrocardiogram, and oxygen saturation should be monitored during the procedure. If the patient is hemodynamically stable, we can begin surgery. If hemodynamic parameters are unstable, we should wait until circulation and respiration become stable. If the patient is still unstable in spite of the treatment, we should postpone the operation. Prophylactic usage of nitroglycerine tape and volume replacement is useful to stabilize hemodynamics and prevent heart attack during surgery in high-risk patients.