Pre-Anaesthetic Clinic

Pre-operative assessment, ASA grading, anaesthesia planning, and fitness clearance

Suresh Patil, 58M — UH-2026-0844

Elective CABG (Cardiac Surgery) · Surgeon: Dr. V. Krishnamurthy

ASA IV
Fit with Conditions

Concerns / Conditions:

  • Severe OSA — AHI 48, CPAP compliance poor. Mandatory CPAP therapy ≥ 3 weeks pre-op.
  • EF 38% — Cardiology clearance obtained.
  • HbA1c 8.2% — target < 7.5% pre-operatively.
  • Metformin stopped 48h pre-op. Insulin sliding scale intraoperatively.
Anaesthesia Plan: General + epidural. HDU/ICU level post-op. Awake fibre-optic intubation planned (difficult airway anticipated).
Consents Required: General anaesthesia, epidural, arterial line, CVC, possible tracheostomy
Confirm CPAP compliance at pre-op visit. Echo repeat if EF changes. Optimise HbA1c. Surgery booked: 28 Jun 2026.

Arjun Reddy, 62M — UH-2026-0838

VATS Right Lower Lobectomy (Thoracic Surgery) · Surgeon: Dr. R. Kumar (Thoracics)

ASA III
Fit for GA

Concerns / Conditions:

  • FEV1 68% predicted — borderline resection margin
  • Active smoker — quit 6 weeks ago (sufficient)
  • DLCO 62% — tolerable for lobectomy
Anaesthesia Plan: GA with double-lumen ETT for one-lung ventilation. Epidural for post-op analgesia.
Consents Required: General anaesthesia, double-lumen tube, epidural, arterial line, CVC
Proceed as planned. Chest physio pre-op. Post-op ICU × 1 day, then HDU.