Postoperative pain management
Patient is coming to an anaesthesiology ambulance prior lobectomy indicated for lung tumor. From the personal history, patient is known to overcome deep venous thrombosis, with subsequent warfarinization. He took warfarin this morning.
We wait till normalization of INR.
After consulting with surgeon we postpone the surgery with 5-day application of LMWH.
Patient can be immediately admitted to surgical department. There is no reason to delay the operation.
Patient is given fresh frozen plasma and vitamin K so we modify the value of INR to 1,2.
60
years
man
RR
19 /min
HR
82 /min
SpO2
96 %
BP
138/82 (101) mmHg
Examination
All pre-op examinations are normal, LMWH - low molecular weight heparin
Glycaemia
Gly
5,7  mmol/L
Complete blood count
HGB
145  g/L
HTC
0,4
ERC
3,7  x1012/L
LEU
4,5  x109/L
PLT
273  x109/L
Biochemical analysis
Na
141  mmol/L
K
3,7  mmol/L
Cl
105  mmol/L
Glycaemia
Take a sample
Complete blood count
Take a sample
Biochemical analysis
Take a sample