Podcast
Questions and Answers
Why is preoperative evaluation considered vital?
Why is preoperative evaluation considered vital?
What is a prime aim of obtaining anesthesia consent during preanesthetic evaluation?
What is a prime aim of obtaining anesthesia consent during preanesthetic evaluation?
What does the ASA classification focus on in predicting perioperative morbidity and mortality?
What does the ASA classification focus on in predicting perioperative morbidity and mortality?
How are healthy pregnant patients in labor classified according to ASA classification?
How are healthy pregnant patients in labor classified according to ASA classification?
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What additional targets are included in a preanesthetic evaluation besides the goals listed?
What additional targets are included in a preanesthetic evaluation besides the goals listed?
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How does preoperative interaction help patients during the evaluation process?
How does preoperative interaction help patients during the evaluation process?
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According to ASA guidelines, how long should a patient wait before proceeding to surgery after being NPO?
According to ASA guidelines, how long should a patient wait before proceeding to surgery after being NPO?
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For a 45-year-old patient with a history of severe anesthesia reaction in a family member, which drug should be avoided for general anesthesia?
For a 45-year-old patient with a history of severe anesthesia reaction in a family member, which drug should be avoided for general anesthesia?
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After a myocardial infarction, how long should elective surgery be postponed for?
After a myocardial infarction, how long should elective surgery be postponed for?
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What is the most significant risk factor for developing pulmonary complications post-surgery?
What is the most significant risk factor for developing pulmonary complications post-surgery?
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What is the maximum international normalized ratio (INR) allowed before proceeding with elective surgery?
What is the maximum international normalized ratio (INR) allowed before proceeding with elective surgery?
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For a 73-year-old patient undergoing laparoscopic cholecystectomy with residual weakness from a stroke, which site should be used to monitor muscle twitches for neuromuscular blockade?
For a 73-year-old patient undergoing laparoscopic cholecystectomy with residual weakness from a stroke, which site should be used to monitor muscle twitches for neuromuscular blockade?
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What is the recommended INR level on the day of surgery to perform a surgical procedure safely?
What is the recommended INR level on the day of surgery to perform a surgical procedure safely?
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Why is it important to rule out left-atrial clots before initiating rate/rhythm control in patients potentially having atrial fibrillation for more than 48 hours?
Why is it important to rule out left-atrial clots before initiating rate/rhythm control in patients potentially having atrial fibrillation for more than 48 hours?
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How long should elective surgery be avoided after a bare-metallic stent placement?
How long should elective surgery be avoided after a bare-metallic stent placement?
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What does ASA III classification indicate in a patient preoperatively?
What does ASA III classification indicate in a patient preoperatively?
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Why is it advised to delay elective laparoscopic surgery after CABG surgery?
Why is it advised to delay elective laparoscopic surgery after CABG surgery?
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In what scenario should warfarin medication be stopped prior to surgery?
In what scenario should warfarin medication be stopped prior to surgery?
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Study Notes
Preoperative Evaluation
- Preoperative evaluation includes a battery of tests, adding to the total perioperative costs.
- It is vital to recognize patient comorbidities, which can worsen perioperatively and cause increased patient morbidity.
- Preoperative evaluation lowers indirect costs that may be incurred to treat the worsening aliment postoperatively.
Goals of Preanesthetic Evaluation
- Educating patients and families about anesthesia and the anesthesiologist's role.
- Obtaining informed consent.
- Motivating patients to stop smoking and lose weight, or commit to other preventive care.
- Explaining the risks and procedure to lower patient anxiety.
ASA Classification
- ASA classification only includes patient-based morbidity, not the type of surgery.
- Healthy pregnant patients in labor are classified as an ASA II.
- Patients with controlled diabetes or essential hypertension are still classified as an ASA II.
Preoperative Preparation
- Elective surgery should be postponed after a myocardial infarction for at least 6 months.
- The maximum international normalized ratio (INR) before proceeding for elective surgery should be 1.4 or less.
- Warfarin should be stopped at least 5 days prior to surgery.
- Before any rate/rhythm control in patients likely to have AF for more than 48 hours, left-atrial clots must be ruled out.
Patient-Specific Considerations
- Patients with a history of reaction to anesthesia should avoid certain drugs during general anesthesia.
- A patient with residual weakness on the right arm and leg following a stroke should be monitored for neuromuscular blockade on the left ulnar nerve.
- Hemodynamically unstable patients secondary to perforation peritonitis may require surgical correction to improve their chances of survival.
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Description
Explore the significance of preoperative evaluation in recognizing patient comorbidities, lowering indirect costs, and reducing patient morbidity. Understand how preoperative evaluation can help in decreasing postoperative complications and alleviating patient anxiety.
