Introduction

In the Previous modules you have learnt the basic concepts of anesthesia and how to apply it to perform surgical and diagnostic procedure using different drugs and equipment in safe environment for different group of patients. Anesthetic care encompasses preparing a safe work environment, understand the effects of drug and how to use equipment, evaluating a patient's health status before surgical or other procedures, developing patient specific anesthesia plan and implementing it, maintaining homeostasis (internal environment) by ensuring a patient does not feel pain during procedures, as well as meeting physiologic need of the patient depending on the monitor in which the patient responses to a variety of drugs and surgical stress are sensed or displayed.

All patient do not require uniform type of anesthesia, anesthetist should prepare patient specific anesthetic plan depending on their surgical procedure, level of health status or the presence of coexisting diseases with their surgical procedures, and available resources. Coexisting medical disease such as hypertension, anemia, ischemic heart disease, bronchial asthma, upper respiratory tract infection, diabetes mellitus, thyroid diseases, renal failure, liver disease, HIV/AIDS are among the common medical problem with these controlled or uncontrolled problems patient came for other surgical procedures.

In this modules the above medical condition are selected as a sample, since they are common in most surgical patient and in the general public. The characteristics of the disease, the general medical management and recommendation for safe anesthesia practice perioperatively are explained. We advice the learner to refer to other anesthesia text books if they are interested to update themselves on the new recommendation and other coexisting diseases that are not addressed in this module.

Hypertension is a frequently encountered abnormality in patients being prepared for surgical procedures. This condition complicates anesthetic and postoperative management, but careful preparation, intraoperative monitoring and treatment allow hypertensive patients to tolerate surgery safely. Management of anesthesia for patients with hypertension includes principles of blood pressure control, preoperative evaluation and management of anesthesia for a patient perioperatively with care to prevent exaggerated systemic blood pressure responses elicited by painful intraoperative stimulation. In this session you will learn to adopt knowledge, skill and right attitude in anesthesia management of coexisting hypertension with the surgical procedure.