You are providing anaesthesia for an elective ENT list. A 63-year-old man with a laryngeal squamous cell carcinoma is booked for a salvage laryngectomy, and neck dissection with a free flap reconstruction.
The patient was seen ten days ago in the preadmission clinic. He was documented to have chronic obstructive airway disease only, with no known cardiovascular disease.
His observations this morning were:
Heart rate 86 beats per minute
Blood pressure 128/75 mmHg
SpO2 95% on room air
Body mass index 18 kg/m2
Medications
Salbutamol 100 mcg via metered-dose inhaler (MDI) PRN
Salmeterol/fluticasone (50/250 mcg) via metered-dose inhaler (MDI) 2 puffs twice daily
Sections covered in this viva
Patient, Surgery and Airway AssessmentIntraoperative ST Depression and Competing InterestsSurgical Fatigue Management