Gracias for your post.
In general, patients with HIV can be managed like HIV- patients, with regard to surgery. Indeed, there is at least one large study from the KP group in California that showed that HIV+ patients did not have any significant increase in perioperative complications (including epidural ones). Following this, the considerations of general versus regional anesthesia are those that apply to the general population.
There are two areas of difference among HIV+s worth noting-- the first is anesthesia management; generally this is not a major area of concern, except for the potential for drug-drug interactions among patients receiving HIV protease inhibitors, especially ritonavir. In these cases a consultation with a pharmacologist prior to anesthesia would be worth while.
Secondly, the issue of having a patient not take anything by mouth (NPO status) can sometimes restrict the intake of HIV medications. If this is only for a 12 hour period, skipping a single or couple of doses can be done without need for treatment or managment modification (though I'd make sure to let the prescribing HIV healthcare provider know; in advance if possible). Longer discontinuations of medications may require some advance planning, particularly if the patient's regimen includes a non-nucleoside inhibitor. Because of significant differences in the half-lives of the nucleosides and non-nucleosides, many experts will recommend discontinuation of the nucleosides for upwards of 7 days prior to a planned discontinuation of non-nucleosides.
Deseo que este es de beneficidad. Nos escribe si hay otras preguntas. BY
