Preoperative Assessment Essay

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ANAESTHETICS Preoperative assessment 1. Aims • The preoperative evaluation consists of gathering information on the patient and formulating an anesthetic plan • The overall objective is reduction of perioperative morbidity and mortality • Ideally, the preoperative evaluation is done by the person who will administer the anesthesia. The anesthetist should review the surgical diagnosis, organ systems involved, and planned procedure • Through interview, physical exam and review of pertinent current and past medical records, the patient’s physical and mental status are determined • All recent medications are recorded and a thorough drug allergy history is taken • The patient should be questioned about the use of cigarettes, alcohol and illicit drugs • The patient’s prior anesthetic experience is of particular interest – specifically, if there has been a history of anesthetic complications, problems with intubation, delayed emergence, malignant hyperthermia, prolonged neuromuscular blockade, or postoperative nausea and vomiting • Informed consent is the communication of the anaesthetic plan, in terms the patient understands, and covers everything from premedication, preoperative procedures, and intraoperative management, through the recovery room and postoperative pain control • The alternatives, potential complications, and risks versus benefits are discussed, and the patient’s questions are answered • In summary, pre-operative care aims to ensure that patients: o Get the right surgery o Are happy and pain free o Are as fit as possible o Have individual decisions on type of anaesthesia/analgesia taking into account risks, benefits and wishes 2. Pre-operative History • Have the symptoms, signs or patient’s wishes changed? • Assess cardiovascular and respiratory systems, exercise tolerance, existing illnesses, drug therapy and allergies • Assess

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