Preoperative health status
BOX 1-18
Management of Patient with Hepatic Insufficiency
1. Attempt to learn the cause of the liver problem; if the I
cause is hepatitis B, take usual precautions.
2. Avoid drugs requiring hepatic metabolism or excretion;
if their use is necessary, modify dose.
3. Screen patients with severe liver disease for bleeding
disorders with platelet count, prothrombin time, partial thromboplastin time, and Ivy bleeding time.
4. Attempt to avoid situations in which the patient
might swallow large amounts of blood.
