Anaesthesia - Techniques Introduction Patients with respiratory disease have an increased chance of developing complications perioperatively. Most problems are seen postoperatively and are usually secondary to shallow breathing, poor lung expansion, basal lung collapse and subsequent infection. To minimise the risk of complications these patients should be identified preoperatively and their pulmonary function optimised. This involves physiotherapy, a review of all medications and may require the help of a respiratory physician.
Elective surgery is postponed until the patient is ready.
The benefits of the proposed surgery must therefore be weighed against the risks involved. Poor exercise tolerance also predicts those at risk. They are at increased risk of perioperative respiratory complications, such as atelectasis or pneumonia. It takes 8 weeks abstinence for this risk to diminish. Even abstinence for the 12 hours before anaesthesia will allow time for clearance of nicotine, a coronary vasoconstrictor, and a fall in the levels of carboxyhaemoglobin thus improving oxygen carriage in the blood.