Physical examination

The anesthesiologist performs a complete physical examination which may include measurement of vital signs, height, weight, as well as assessment of the airways. Oral cavity inspection, auscultation of the lungs and pulmonary function are tests commonly used in the preoperative anesthesia evaluation. The physician may order additional preoperative tests if necessary or make use of the medical records you already have. Consequently, the physician classifies your physical condition according to some clinical parameters.

The physical examination may include the following factors:

In this consultation the anesthesiologist may indicate to continue in the using of certain medications or may give new instructions for your clinical management prior to surgery. Also, you will be asked to follow the doctor´s instructions about diet, hygiene, dental prothesis, postoperative recommendations, etc.

The preanesthesia evaluation comprehends much more than obtaining information or medical records. This process may be used to prepare the patient for the anesthesia and the postoperative management of pain.

Preventive measures

Complications resulting from anesthesia have declined dramatically over last years. Thanks to the preoperative evaluation and the intraoperative monitoring, Colombia has a low annual incidence of anesthesia complications. These methods allow physicians to identify any disease or disorder that may increase the possibility of adverse perioperative events. Every patient who undergoes surgery has an interview with the anesthesiologist. The information resulting from this interview is the preanesthesia evaluation and is used during surgery and placed in a very visible site in the operating room. Preanesthesia evaluation considers information from multiple sources that may include the physical examination and other paraclinical tests. In the same manner, the patient signs an informed consent whereby the patient declares to have a clear appreciation and understanding of the facts, implications and consequences of the anesthesia and the surgical procedure.

Once the preanesthesia evaluation has taken place, patients seem to be less anxious since they can confirm the physician has developed an anesthetic plan to minimize possible risks for his safety. In this way, during surgery the anesthesiologist takes care of all vital signs such as pulse rate, blood pressure, respiratory rate and temperature, as well as other physiological functions. Every operating room employs devices to monitor patients´ vital signs, electronic CPR systems (Cardiopulmonary resuscitation), as well as a cardiac defibrillator to provide the most efficient treatment in case of complications during surgery. In that manner, the preanesthesia evaluation may decrease the postoperative discomfort, possible complications, and may promote recovery.

Antiembolic prophylaxis

What is the Antiembolic prophylaxis?

Venous thromboembolism is one of the risks in plastic surgery procedures. However, thromboprophylaxis prevention may decrease complications in patients who undergo surgery. Dr. Nieto`s patients receive the most appropriate methods of prophylaxis for his or her individual condition to prevent thromboembolism. Some mechanical devices and chemical regimens are a good option for preventing blood clots and may reduce but no eliminate the risk of venous thromboembolism. Hemostasis is a complex defense mechanism that prevents excessive blood loss (hemorrhage). Part of the response to injury, e.g. as part of a surgical procedure, is the stimulation of the hemostatic system. The hemostatic system generates an insoluble form that is deposited at the site of injury. However, in this natural process an unwanted blood clot or thrombus may form decreasing blood flow. If the thrombus dislodges and migrates from one part of the body may cause a blockage of a blood vessel in another part of the body, it is termed as an embolus. Even though signs and symptoms are nonspecific to detect this disease, the surgeon may develop a treatment to prevent the risk of thromboembolism.

Each patient receives the appropriate method of prophylaxis before, during and after the procedure. Besides adequate position and early deambulation, Dr. Nieto routinely uses elastic and pneumatic compression devices, as well as anticoagulant medications to prevent venous thromboembolism.
Dr. Nieto´s Antiembolic prophylaxis includes: