The patient is a 64-year-old male who had chemotherapy four weeks and three days ago. He also has diabetes. He has been advised to get the surgery immediately. We have been told that anesthesia could be dangerous for him. I will attach the prescribed medicines he has been taking for chemotherapy. Could you please let us know if anesthesia would be dangerous, considering the patient's condition? Do you recommend this as an emergency surgery? Would you please give your valuable advice on this?
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Thanks for writing in, and I understand your concern. We have to evaluate the patient regarding his overall clinical status. If it is emergency surgery, we have to weigh the risks and benefits of the surgery. So, in this case, I need more information about the patient, like his comorbidities, what kind of surgery he needs, his cardiac status, and the primary disease for which he needed chemotherapy. Would you please give me your answers to these?
Thank you for your response.
The patient has been under treatment for spinal cord metastasis. He has diabetes, and his cardiac condition was normal before. The metastatic cells around his spinal cord are considered cancerous with an unknown source, so he has undergone chemotherapy. The cells caused fractures and complications that needed surgical intervention to control the condition.
Welcome back to icliniq.com.
Based on your reports (attachments removed to protect the patient's identity), the patient needs surgery on an urgent basis to prevent further neurological damage and compression of the spinal cord and early mobilization and rehabilitation. However, chemotherapeutic agents like Carboplatin are nephrotoxic, and Paclitaxel is also toxic to the lungs. Apart from that, all chemotherapeutic agents cause myelosuppression that is decreased number of blood cells. An anesthesiologist will assess him for a pre-anesthetic check-up if his surgery is scheduled. He will order all the necessary investigations like blood counts, 2D echocardiography, chest X-ray, or computed tomography (CT) scans, and others will be managed accordingly. The anesthesiologist will ensure that surgery has more benefits than harm to the patient. So you should elaborate the detailed history to him whenever you are asked to do so. I am very sure that he will be in good hands.
I hope this answers your question.
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