Valvular Heart Disease

The availability of echocardiography today means that any patient with suspected valve disease should be properly investigated and a diagnosis made prior to anaesthesia. Valve angioplasty or replacement is sometimes indicated before elective surgery. Unfortunately, patients with significant valve disease may still present for emergency surgery. Any patient with a heart valve lesion, including replacement valves, requires prophylactic antibiotics for dental, genitourinary, obstetric,...

Post Operative Nausea and Vomiting

Post operative nausea and vomiting PONV is one of the commonest complications in the post operative period despite the use of modern day anaesthetic techniques. It occurs in 20-40 of cases and results in patient discomfort and anxiety and can produce significant morbidity in some cases. In the immediate post operative period the patient is at increased risk of aspiration. Sudden increases in intra-ocular and intracranial pressure associated with vomiting may be detrimental in the ophthalmic and...