Check drug history (steroids,
cardiac drugs). Investigations include ECG, echocardiography, chest
radiography, arterial blood gases, and levels of electrolytes, urea,
creatinine, and hemoglobin. In patients with preexisting permanent
pacemaker, ascertain pacemaker function according to institution protocol. A
magnet or reprogramming device and expertise that can be used to convert the
pacemaker to asynchronous mode should be available. In patients without
preexisting permanent pacemaker, measures and expertise for temporary pacing
(cardiologist, transcutaneous pacing, transesophageal pacing, transvenous
pacing) should be available prior to induction of anesthesia. Chronotropic
drugs (atropine, isoprenaline) should be available.