How to Handle Alcoholic Patients in Clinically Anesthetic Practice?

Abstract

Liquor is socially demeaning that frustrates human heart and soul. However, its consumption has tendency to increase annually. Medical personnel have responsibilities not only to educate and prevent society from intoxicating liquor but also to nurse and foster their patients back to normal lives. Alcohol absorption through gastrointestinal tract depends upon physical condition, volume and duration of drinking, plasma concentration and excretion. Alcohol is metabolized in liver by enzyme cytochrome P450. It mainly depresses the central nervous system. Heavy and extensive drinking can cause alcohol intoxication and chronic alcohol dependence; however, abrupt halt of ingestion can be alcohol withdrawal. Preoperative evaluation is crucial prior to commence of anesthesia. Normally, administration of thiamine is recommended to alleviate alcoholic encephalopathy. In general anesthesia, personnel should perform rapid sequence intubation with cricoid pressure as patients are at risk of pulmonary aspiration. As a precaution, patients with liver impairment have decreased plasma albumin resulting in less enzyme cytochrome P450, more free drugs and volume of distribution as well as prolong anesthetics effects. Since liquor drinking impedes organs function repetitively, these affect patients to have long hospital stays after surgery