Assessment and management of the patient with Cirrhosis undergoing surgery

A significant number of cirrhotic patients require nonhepatic surgery, most frequently repair of hernias, cholecystectomy, and peripheral surgery. The perioperative management of these patients can be challenging and there are limited controlled data to guide clinical decision making. Similarly, there are few controlled studies on pain management in cirrhotic patients, such that both the management of pain and surgical management of these patients are largely empirical, guided by clinical outcomes and case series. In this chapter, we review the perioperative management and use of analgesics in this population.