07-31-2009, 04:53 PM
A 60-year-old man undergoes preoperative evaluation before total hip-replacement surgery. His history includes asthma and obstructive sleep apnea (OSA) but no known coronary artery disease. He also has osteoarthritis of the knee, which does not allow him to walk far without pain, although he is able to perform yard activities that do not require much walking, such as weeding, pruning trees, and splitting wood. His medications include flunisolide, salmeterol, and albuterol as needed. He also uses positive continuous airway pressure at night.
On physical examination, the BMI is 31. Blood pressure is normal, and oxygen saturation is 90% on room air. Scattered wheezes are heard on pulmonary examination. The remainder of the examination is unremarkable.
Which of the following preoperative strategies will most reduce this patient's risk for postoperative pulmonary complications?
A. Five percent weight loss
B. Improved asthma control
C. Surgical correction of OSA
d. Preoperative spirometry
On physical examination, the BMI is 31. Blood pressure is normal, and oxygen saturation is 90% on room air. Scattered wheezes are heard on pulmonary examination. The remainder of the examination is unremarkable.
Which of the following preoperative strategies will most reduce this patient's risk for postoperative pulmonary complications?
A. Five percent weight loss
B. Improved asthma control
C. Surgical correction of OSA
d. Preoperative spirometry