A 45-year-old patient is assessed for suitability for day-surgery. Which condition would constitute an ABSOLUTE contraindication to ambulatory (day-care) surgery?

• A ASA physical status III diabetes mellitus well-controlled with oral agents
• B BMI 38 kg/m² with no OSA symptoms
• C Active unstable angina with recent MI 2 weeks ago ✓
• D Former premature infant now 15 months corrected age

Explanation

Active unstable angina or recent myocardial infarction (within 4–6 weeks) is an absolute contraindication to elective day-surgery due to the unacceptably high risk of perioperative major adverse cardiac events (MACE), which cannot be managed in an ambulatory setting without ICU/CCU capability. Well-controlled ASA III conditions (diabetes, hypertension, controlled asthma) are acceptable for appropriately selected day-surgery procedures. BMI 38 alone is a relative consideration requiring OSA assessment. Former premature infants <60 weeks post-conceptual age have apnoea risk — the threshold is generally <60 weeks PCA for most centers.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.