Anesthesia Considerations for Patients with ASA 2 and Oncological Status

Preoperative Evaluation

The American Society of Anesthesiologists (ASA) defines patients with ASA 2 as those with mild systemic disease without functional limitation 3
A Karnofsky Performance Status (KPS) of 90 indicates very good functional ability, with the patient able to perform normal activities with minimal signs or symptoms of disease 4
The combination of ASA 2 and KPS 90 places the patient in a moderate risk category that can be managed with standard anesthesia protocols 1, 2

The European Society of Cardiology recommends that occasional premature ventricular contractions (PVCs) in patients without significant structural heart disease do not require specific therapy or changes in anesthesia management 5
A left ventricular ejection fraction (LVEF) of 68% indicates normal and very good left ventricular systolic function 6, 7
Mild tricuspid regurgitation (TR) with low probability of pulmonary hypertension does not alter anesthesia management for ASA 2 patients 6
The American Heart Association recommends that patients with normal cardiac function do not require invasive hemodynamic monitoring or transesophageal echocardiography (TEE) intraoperatively 6, 7

The American Society of Anesthesiologists (ASA) recommends that general or regional anesthesia can be used safely depending on the type of surgery 1, 2
If general anesthesia is used, ensure a secure airway with endotracheal intubation for procedures that may compromise the airway 1, 2
There are no contraindications to standard anesthesia techniques in these patients 1, 2

The American Society of Anesthesiologists (ASA) recommends the following minimal monitoring: continuous EKG 6, pulse oximetry 2, non-invasive blood pressure 5, oxygen inspiratory concentration 4, capnography (CO2 end-tidal) 4, airway pressure 1, and frequency and volume of ventilation 7
Core body temperature monitoring is also recommended 1
A peripheral nerve stimulator should be used if neuromuscular blocking agents are administered 6

The European Society of Cardiology recommends maintaining normotension and avoiding excessive tachycardia 6, 5
If hypotension occurs, use phenylephrine or norepinephrine to increase blood pressure 6, 2

The American Society of Anesthesiologists (ASA) recommends that patients can receive standard care in the recovery room without additional special monitoring 1, 2
Extubation should be performed when the patient is fully awake with complete reversal of neuromuscular blockade 2
Verification of complete reversal of neuromuscular blockade is necessary before extubation 2

The American Society of Anesthesiologists (ASA) recommends documenting ASA physical status, functional status (KPS), and cardiovascular findings in the pre-anesthesia medical record 1
All medications administered, including doses and times, should be documented 8
Monitoring used and hemodynamic parameters during the procedure should be recorded 1