Principles of Preoperative Evaluation

Preoperative Risk Assessment and Stratification

Preoperative evaluation is a critical process in anaesthesiology that aims to identify and mitigate potential surgical risks while optimizing patient outcomes.

Importance of Preoperative Evaluation

Assessing a patient's medical history, comorbidities, and current health status is crucial for determining their surgical risk and establishing appropriate perioperative management strategies.

Key Components of Preoperative Evaluation

• Medical History: Review of underlying conditions such as cardiovascular disease, diabetes, and respiratory disorders.
• Physical Examination: Assessment of vital signs, airway evaluation, and cardiac/pulmonary function.
• Laboratory Tests: Includes blood tests, electrolyte levels, kidney function tests, and coagulation profile.
• Cardiopulmonary Assessment: Electrocardiogram (ECG) and pulmonary function tests for high-risk patients.

Risk Stratification Systems

Several validated scoring systems help assess surgical risk:

• ASA Classification: Categorizes patients based on overall health status.
• Revised Cardiac Risk Index (RCRI): Evaluates the risk of perioperative cardiac events.
• Caprini Score: Assesses venous thromboembolism risk.

Optimization Strategies

Preoperative optimization involves stabilizing medical conditions, managing medications, and employing risk-reduction interventions such as smoking cessation and glycemic control.

Conclusion

A thorough preoperative evaluation ensures that patients are adequately prepared for surgery, minimizing complications and improving overall surgical outcomes.