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Rheumatoid arthritis (Airway (Influence on anaesthesia (Consider MRI preop…
Rheumatoid arthritis
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Respiratory
Changes
Impaired gas exchange: pleural effusion, rheumatoid nodules, pulmonary fibrosis
Restrictive ventilatory defect (rare): decreased FEV1, FVR, thoracic spine involvement
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CVS
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Influence of anaesthesis
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May alter haemodynamic goals (rate, BP etc.) especially if regional anaesthesia used
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Haematological
Changes
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Increased risk of bleeding if chronic NSAIDS, steroids
Impaired marrow function, thrombocytopenia from disease or treatment e.g. azathioprine, methotrexate
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Renal
Changes
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May be exacerbated by therapy (NSAIDS, DMARDS e.g. cyclosporin)
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Endocrine
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Influence on anaesthetic
BSL management periop, may require insulin sliding scale
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Immune - Likely immunosuppressed from disease and treatment - meticulous attention to sterile technique
Skin - Thin, fragile - lines may be difficult, meticulous care on transfers, padding and protection