Criteria

Appropriate

Contra-indications

Age

No upper age limit

Age < 1 year

Body Mass Index

BMI < 30

BMI > 30

Cardiovascular

Healthy patient

1) No systemic disturbance

2) Mid/moderate disturbance

Controlled hypertension, ECG required

MI within last 6 months

CVA or TIA within 1 year

Aphasic patients

BP systolic > 160

      Diastolic >110

Warfarin treatment –contact treating surgeon

Angina classification 3 + 4 NYHA classification

Uncontrolled or poorly controlled cardiac failure

Orthopnoea

Heart Block

Symptomatic congenital  cardiac disease

Symptomatic valvular disease

Aortic Stenosis

Recent bypass surgery

Post cardiac transplant

Un-investigated heart murmur

Significant or unexplained arrhythmia

Endocrine System

NIDDM

Oral hypoglycaemic therapy -  instruct patient to omit morning dose, starve as instructed and bring medication with them

IDDM

Chronic liver disease

Uncontrolled thyrotoxicoses or hypothyroidism

High dose steroid therapy

Renal failure

Polyuria

Haematology

Hb < 10g/dl

Haemophilia

Clotting disorders

MAOI Therapy

Neuromuscular

Full range of movement in all limbs

No systemic disturbance

Controlled epilepsy

Arthritis of neck/ jaw limiting movement

Cervical spondylosis

Myasthenia, myopathies, neuropathies

M.S

Uncontrolled epilepsy

Respiratory

No dyspnoea

No systemic disturbance

Controlled epilepsy

Severe/ uncontrolled asthma

Bronchiectasis

Emphysema

Social

Access to telephone

24hr carer available

No access to telephone

No adult cover for 24 hour post procedure

Drug or alcohol addiction

Other

Pregnancy

Non ambulant - underlying pathology

Non independent special needs patients

Patients with a history of anaesthetic problems