Introduction and Evolution of Preoperative Evaluation

Anotacoes

28: Preoperative Evaluation Duminda N. Wijeysundera, and Emily Finlayson KEY POINTS ▪ The anesthesia preoperative evaluation, which is the clinical foundation for guiding perioperative patient management, reduces perioperative morbidity and enhances patient outcome. ▪ The fundamental purpose of preoperative evaluation is to obtain pertinent information regarding the patient’s medical history, formulate an assessment of the patient’s perioperative risk, and develop a plan for any clinical optimization. ▪ The pre-anesthesia evaluation should include a focused clinical examination, documentation of comorbid illness, reduction of patients’ anxiety through education, assurance that preexisting medical conditions are optimally managed, selective referrals to medical specialists, ordering of preoperative investigations, initiation of interventions intended to decrease risk, discussion of aspects of perioperative care, arrangements for appropriate postoperative care, and recommendations to delay or cancel the surgical procedure, if deemed appropriate. ▪ Comorbid medical diseases can influence anesthesia and perioperative management, thus requiring the anesthesiologist to be knowledgeable i...