28: Preope

Anotacoes

•Preoperative Evaluation Duminda N. Wijeysundera and Emily Finlayson KEY POINTS ▪ The anesthesia preoperative evaluation forms the clinical foundation for guiding perioperative patient management, reducing morbidity, and improving outcomes. ▪ Its primary purpose is to gather relevant medical history, assess perioperative risk, and develop a plan for clinical optimization. ▪ The evaluation should include a focused clinical exam, documentation of comorbidities, patient education to reduce anxiety, confirmation of optimal management of existing conditions, referrals to specialists, preoperative investigations, risk-reducing interventions, discussions about perioperative care, arrangements for postoperative care, and considerations to delay or cancel surgery if necessary. ▪ Comorbid medical diseases influence anesthesia and perioperative management, requiring anesthesiologists to be knowledgeable in internal medicine. ▪ Patients need appropriate diagnostic and laboratory studies aligned with their medical history and the surgical procedure. Routine testing without indication is unjustified due to cost and clinical irrelevance. ▪ An anesthesiologist-led outpatient preopera...