ABSTRACT
Systemic sympathetic flow can be increased because of a systemic inflammatory response due to trauma or surgery itself. Fibrinolytic treatment is generally not an option given surgery and risk of bleeding, but this again is best addressed with interdisciplinary input. Since the triggering mechanism of pain in atrial fibrillation is most likely common to all types of surgery, then control of pain becomes important in both the prophylaxis and treatment of atrial fibrillation. Guidelines for the prevention of venous thromboembolism in orthopaedic surgery patients were recently revised. Absolute contraindications to anticoagulation are malignant hypertension, intracranial bleeding, severe active bleeding or recent brain, eye or spinal surgery. Central to preventing kidney dysfunction perioperatively in older adults is avoiding hypotension and prolonged hypoperfusion of the kidney. Consider limiting the number of hypotensive medications given on the day of surgery or setting hold parameters based on blood pressure throughout the perioperative period.
