The Patient with Liver Disease

Abstract

The patient with liver disease presents the anaesthetist with a medley of deranged physiology. The variations are of sufficient magnitude that a formula to handle all the conceivable problems is not possible. First and foremost, these patients have a very high morbidity and mortality for surgery. Therefore it is wise to obtain as much preoperative information as possible and Table 6 outlines the 'Arizona protocol’ for preoperative evaluation. It provides, in capsule form, guidelines which can be applied to the patient with cirrhosis who is being prepared for major surgery.