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Chapter 14 - Understanding the Role of the Anesthesia Preop Evaluation

Published online by Cambridge University Press:  21 February 2025

Dharti Patel
Affiliation:
Mount Sinai West and Morningside Hospitals, New York
Sang J. Kim
Affiliation:
Hospital for Special Surgery, New York
Himani V. Bhatt
Affiliation:
Mount Sinai West and Morningside Hospitals, New York
Alopi M. Patel
Affiliation:
Rutgers Robert Wood Johnson Medical School, New Jersey
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Summary

This chapter reviews the role and importance of preoperative assessment and evaluation. Preoperative assessments are designed to prepare patients to undergo anesthesia and surgery while incurring as little risk as possible. The preoperative assessment gives the opportunity to collect patient information (through patient and/or family interviews centered on medical and anesthesia histories and medication lists, identify and stratify the risk in the hope of mitigating it by optimization of the patient’s conditions. Assessing the patient’s medical and surgical risks in the context of evidence-based guidelines is used to implement rational decision making when ordering appropriate additional workup (such as lab work or cardiac or pulmonary testing). Education regarding what to expect and how to prepare for anesthesia and surgery may also reduce the patient’s and family’s anxiety.

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BASIC Essentials
A Comprehensive Review for the Anesthesiology BASIC Exam
, pp. 77 - 79
Publisher: Cambridge University Press
Print publication year: 2025

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References

Forkin, KT, Nemergut, EC. Anesthesiology. In Miller, R, editor. Miller’s Anesthesia, 8th ed. Churchill Livingstone/Elsevier, 2016; pp 977978.Google Scholar
Committee on Standard and Practice Parameters, et al. Practice Advisory for Preanesthesia Evaluation: an updated report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Anesthesiology 2012;116(3):522538.CrossRefGoogle Scholar
Fleisher, LA, Fleischmann, KE, Auerbach, AD, et al. American College of Cardiology; American Heart Association. 2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol 2014 Dec 9;64(22):e77137.CrossRefGoogle Scholar
Moonesinghe, SR, Mythen, MG, Das, P, Rowan, KM, Grocott, MP. Risk stratification tools for predicting morbidity and mortality in adult patients undergoing major surgery: qualitative systematic review. Anesthesiology 2013 Oct;119(4):959–981.CrossRefGoogle ScholarPubMed
National Guideline Centre (UK). Preoperative Tests (Update): Routine Preoperative Tests for Elective Surgery. London: National Institute for Health and Care Excellence (NICE), 2016 Apr. (NICE Guideline No. 45), p 1, Guideline summary.Google Scholar

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