The Preoperative Patient Evaluation

Abstract

The preoperative evaluation consists of more than the preanesthesia assessment or clearance for surgery. This preoperative patient encounter may be the patient’s first examination by a physician in quite some time. Therefore, a detailed medical evaluation and comorbidity risk assessment relative to the risk of the surgical procedure is required. The key components of an effective preoperative evaluation include a thorough history, review of systems, assessment of functional status, and physical examination. Combining this information with the current list of medications provides enough data to assess fitness for surgery using risk calculators or biomarkers, ascertain whether prehabilitation or further testing is needed, and engage in shared decision making with the patient. This supports a valued-based, patient centric care model and improves understanding of surgical and anesthetic risks. This serves to facilitate informed consent facilitating conversations regarding postoperative expectations. The aforementioned information is critical to establishing whether the procedure is best for the patient under current physiologic conditions or if alternative treatment strategies should be considered.