Key result
Patients with a prior history of stroke face a higher risk of perioperative stroke and neurological deficits, requiring careful optimization of modifiable risk factors, appropriate surgical timing, and close monitoring.
Careful perioperative management, including delaying elective surgery 3 to 9 months post-stroke and optimizing hemodynamics and medications, is crucial to reduce perioperative stroke risk.
Prior stroke patients need heightened perioperative caution; limited evidence leaves specific noncardiac surgery guidelines open.
An increasing number of patients with a prior history of stroke present for various types of surgeries. They have varying degree of neurological disability and associated co-morbidities, which pose challenges for their perioperative management. There is paucity in literature about their management guidelines for noncardiac, noncarotid surgeries. The available literature suggests higher risk of perioperative stroke, postoperative neurological deficits, and other morbidities. Measures to reduce perioperative risks are discussed in this review. Prior optimization by improving modifiable risk factors, choosing appropriate timing of elective surgery, and careful titration of anesthesia and close monitoring are needed.
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Karnik et al. (2018) conducted a review in Prior stroke. Perioperative management and anesthesia was evaluated. Patients with a prior history of stroke face a higher risk of perioperative stroke and neurological deficits, requiring careful optimization of modifiable risk factors, appropriate surgical timing, and close monitoring.
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