Alcohol Abuse




Risk





  • Incidence in USA: 10% of Americans, incl physicians, will abuse alcohol at some point in their lives.



  • 1:5 surgical pts has some form of alcohol use disorder.



  • Third leading cause of death and disability, incl 30% of traffic fatalities.



  • Male gender and family Hx major are risk factors.





Perioperative Risks





  • Severe malnutrition as significant as ETOH-induced end-organ injury.



  • Risk of Htn, CVA, diabetes, GI disease.



  • Liver is the most severely affected organ.



  • Dilated cardiomyopathy.



  • Withdrawal symptoms can be life threatening.





Perioperative Risks





  • Severe malnutrition as significant as ETOH-induced end-organ injury.



  • Risk of Htn, CVA, diabetes, GI disease.



  • Liver is the most severely affected organ.



  • Dilated cardiomyopathy.



  • Withdrawal symptoms can be life threatening.





Worry About





  • Concomitant use of other drugs: Amphetamines, cocaine, benzodiazepines.



  • Affects of chronic smoking, such as COPD and emphysema.



  • Vasopressor effect of ETOH may cause Htn.



  • Acute withdrawal and delirium tremens are life-threatening complications. Symptoms caused by sympathetic stimulation can range from mild tremors to electrolyte disturbances, seizures, and death.





Overview





  • Disease characterized by addiction (compulsion and craving despite consequences) to alcohol.



  • Clinical syndromes related to direct effect of ETOH and secondary adaptive response to excess ETOH exposure.



  • ETOH rapidly absorbed and metabolized.



  • Hepatic dysfunction usually takes 10 to 15 y to develop.



  • Cirrhosis may develop after 1 or more acute episodes.



Sep 1, 2018 | Posted by in ANESTHESIA | Comments Off on Alcohol Abuse

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