The AHA/ACC clinical practice guidelines for perioperative cardiovascular management for noncardiac surgery have recently been reviewed. While oral surgeons aren’t likely to perform high-risk surgery, it is important to know what these guidelines suggest to avoid perioperative complications. To break down these guidelines, we are joined by Dr. David Salomon. In this conversation, you’ll hear all about why we decided to discuss pre-op anesthesia considerations today, how the 2014 AHA/ACC guidelines differ from the 2024 ones, some key points in the new guidelines, and how they have changed how Dr. Salomon practices medicine. We delve into what a high-risk surgery is, how to identify a high-risk surgery, and what the seven risk modifiers mentioned in the study are before discussing the three possible next steps a surgeon will follow once they’ve done a risk analysis. Dr. Salomon even stresses the importance of asking the patient about functional capacity and shares how these guidelines have helped him be aware of what’s important to consider pre-op. Finally, our guest cautions surgeons against over-testing as well. Thanks for tuning in!
Key Points From This Episode:
- Welcoming Dr. David Salomon back to the show.
- Why we’re talking about pre-op anesthesia today.
- What he thinks of the 2024 clinical practice guidelines.
- Dr. Salomon breaks down the 2014 guidelines.
- What a high-risk surgery is and how to identify one.
- Some key points in the new guidelines.
- SGL2 inhibitors and what the guidelines say about them pre-op.
- Breaking down the seven risk modifiers the guidelines discuss.
- How MIs and strokes come into play when considering a patient’s risk factors.
- Considering the frailty of a patient, what it actually is, and frailty assessment tools.
- How these guidelines have changed Dr. Salomon’s practice.
- The next perioperative steps for surgeons to follow according to the guidelines.
- The importance of functional capacity and METS and what they tell us.
- Recommendations about patients with hypertension.
- How these guidelines have made our guest consider what is truly important pre-op.
- Why Dr. Salomon doesn’t agree with over testing.
Links Mentioned in Today’s Episode:
Dr. David Salomon on LinkedIn — https://www.linkedin.com/in/david-salomon-b8ab1431/
2024 AHA/ACC Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery (JACC Journals) — https://www.jacc.org/doi/10.1016/j.jacc.2024.06.013
2024 AHA/ACC Guideline for Perioperative Cardiovascular Management for Noncardiac Surgery (AHA/ASA Journals) — https://www.ahajournals.org/doi/10.1161/CIR.0000000000001285
Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/
Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/
Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/
Dr. Grant Stucki Email — grantstucki@gmail.com
Dr. Grant Stucki Phone — 720-441-6059
