Confirm the surgical procedure and indication for surgery.See “ Emergency preoperative evaluation” for patients needing emergency surgery. The following applies primarily to patients having elective surgery.
See also “ Postoperative management.” OverviewĪ preoperative evaluation is performed to determine whether a patient is in optimal health for a planned surgical procedure and its extent depends on the urgency of the surgery. Patients having emergent surgery still require evaluation even though opportunities for management beyond resuscitation are typically limited. Low-risk patients having low-risk surgery seldom need testing or intervention, while patients with a high disease burden having high-risk surgery often require extensive testing, consultation, and possible postponement of surgery. The extent of patient evaluation and preparation varies according to both the proposed surgery and the patient's functional status.
This includes optimization of medical treatment, specialty consultation for advanced disease management, patient education on lifestyle modifications, and instruction on day-of- surgery oral intake and medication use. Preoperative preparation enhances surgical outcomes by improving the patient's functional status, mitigating identified risk factors, and optimizing perioperative medication regimens. Important components of the preoperative evaluation are a thorough history and physical examination, identification of patients at greatest risk of a perioperative adverse event, and appropriate diagnostic testing. The purpose of a preoperative evaluation is to assess whether a patient is medically optimized for the stress of surgery and to identify reversible factors that may increase the perioperative risk for the patient.
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