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Article ; Online: Preoperative evaluation and preparation for anesthesia and surgery.

Zambouri, A

2009 Volume 11, Issue 1, Page(s) 13–21

Abstract: ... of the expected operation as well as the findings of the diagnostic workup and the preoperative evaluation. ... anesthetic perioperative morbidity or mortality, and to return him to desirable functioning as quickly ... of anesthetic administered. A history and physical examination, focusing on risk factors for cardiac and ...

Abstract	The ultimate goals of preoperative medical assessment are to reduce the patient's surgical and anesthetic perioperative morbidity or mortality, and to return him to desirable functioning as quickly as possible. It is imperative to realize that "perioperative" risk is multifactorial and a function of the preoperative medical condition of the patient, the invasiveness of the surgical procedure and the type of anesthetic administered. A history and physical examination, focusing on risk factors for cardiac and pulmonary complications and a determination of the patient's functional capacity, are essential to any preoperative evaluation. Laboratory investigations should be ordered only when indicated by the patient's medical status, drug therapy, or the nature of the proposed procedure and not on a routine basis. Persons without concomitant medical problems may need little more than a quick medical review. Those with comorbidity should be optimized for the procedure. Proper consultations with appropriate medical services should be obtained to improve the patient's health. These consultations should ideally not be done in a "last second" fashion. The preoperative preparation involves procedures that are implemented based on the nature of the expected operation as well as the findings of the diagnostic workup and the preoperative evaluation.
Language	English
Publishing date	2009-07-02
Publishing country	Greece
Document type	Journal Article
ZDB-ID	2491943-3
ISSN	1790-8019 ; 1108-4189
ISSN (online)	1790-8019
ISSN	1108-4189
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Article ; Online: Preoperative Evaluation and Care of Heart Transplant Candidates.

Hwang, Nian Chih / Sivathasan, Cumaraswamy

Journal of cardiothoracic and vascular anesthesia

2022 Volume 36, Issue 11, Page(s) 4161–4172

Abstract: ... for heart transplantation, they undergo comprehensive evaluation and preparation to optimize their posttransplantation ... and device therapy, and who do not have absolute contraindications. When patients become eligible ...

Abstract	Heart transplantation is recommended for patients with advanced heart failure refractory to medical and device therapy, and who do not have absolute contraindications. When patients become eligible for heart transplantation, they undergo comprehensive evaluation and preparation to optimize their posttransplantation outcomes. This review provides an overview of the processes that are employed to enable the candidates to be transplant-ready when donor hearts are available.
MeSH term(s)	Heart Failure/diagnosis ; Heart Failure/surgery ; Heart Transplantation ; Humans ; Tissue Donors
Language	English
Publishing date	2022-07-14
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	1067317-9
ISSN	1532-8422 ; 1053-0770
ISSN (online)	1532-8422
ISSN	1053-0770
DOI	10.1053/j.jvca.2022.07.008
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Article: Preoperative preparation and premedication of bariatric surgical patient.

Varbanova, Marina / Maggard, Brittany / Lenhardt, Rainer

Saudi journal of anaesthesia

2022 Volume 16, Issue 3, Page(s) 287–298

Abstract: ... of the preoperative anesthesia assessment and patient preparation in the patient suffering from obesity include ... weight loss surgeries and their implications on the upcoming anesthetic. The preoperative evaluation ... A detailed and thorough anesthesia assessment should be performed, and the anesthesia plan individualized and ...

Abstract	The prevalence of obesity has tripled worldwide over the past four decades. The United States has the highest rates of obesity, with 88% of the population being overweight and 36% obese. The UK has the sixth highest prevalence of obesity. The problem of obesity is not isolated to the developed world and has increasingly become an issue in the developing world as well. Obesity carries an increased risk of many serious diseases and health conditions, including type 2 diabetes, heart disease, stroke, sleep apnea, and certain cancers. Our ability to take care of this population safely throughout the perioperative period begins with a thorough and in-depth preoperative assessment and meticulous preparation. The preoperative assessment begins with being able to identify patients who suffer from obesity by using diagnostic criteria and, furthermore, being able to identify patients whose obesity is causing pathologic and physiologic changes. A detailed and thorough anesthesia assessment should be performed, and the anesthesia plan individualized and tailored to the specific patient's risk factors and comorbidities. The important components of the preoperative anesthesia assessment and patient preparation in the patient suffering from obesity include history and physical examination, airway assessment, medical comorbidities evaluation, functional status determination, risk assessment, preoperative testing, current weight loss medication, and review of any prior weight loss surgeries and their implications on the upcoming anesthetic. The preoperative evaluation of this population should occur with sufficient time before the planned operation to allow for modifications of the preoperative management without needing to delay surgery as the perioperative management of patients suffering from obesity presents significant practical and organizational challenges.
Language	English
Publishing date	2022-06-20
Publishing country	India
Document type	Journal Article ; Review
ZDB-ID	2562174-9
ISSN	0975-3125 ; 1658-354X
ISSN (online)	0975-3125
ISSN	1658-354X
DOI	10.4103/sja.sja_140_22
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Article: Educating Family Physician Residents for Anesthetic Preoperative Evaluation and Assessment.

Gerber, Ben / Roth, Eyan P / Laubach, Tyler A / De Jong, Luke / Kasper, Travis J / Perry, Jarrett / Johnson, Allan / Krogman, William L / Newton, Felecia A / Powell, Sara / Bragg, Dee Ann / Regehr, Jared

Kansas journal of medicine

2023 Volume 16, Page(s) 234–236

Abstract: ... We assessed family medicine residents' knowledge of preoperative evaluation in preparation for surgery ... and residency-based curriculum related to preoperative patient evaluation. ... by providing a pre- and post-test alongside a didactic seminar.: Methods: A didactic seminar on preoperative ...

Abstract	Introduction: Encounters for preoperative assessments are common within primary care offices, so it is imperative that family medicine residents learn how to perform preoperative evaluations. We assessed family medicine residents' knowledge of preoperative evaluation in preparation for surgery by providing a pre- and post-test alongside a didactic seminar. Methods: A didactic seminar on preoperative evaluations was presented at a family medicine resident didactics session by two senior anesthesiology residents. A 16-question, multiple choice test was used as both a pre-test and post-test to assess family medicine residents' knowledge. Results: A total of 31 participants took the pre-test (residents = 24; medical students = 7), and 30 participants took the post-test (residents = 23; medical students = 7). Mean scores and standard deviations were calculated for both tests with an average score of 37.50% ± 10.58% and 45.42% ± 11.12% on the pre- and post-test, respectively. Using the Kruskal-Wallis test, residents showed a significant improvement in test scores following the didactic presentation (p = 0.041), while overall results (residents and medical students) also reported a significant difference (p = 0.004). Conclusions: Our results demonstrated that educating family medicine residents and medical students on preoperative evaluation showed significant, quantifiable gains in knowledge following a brief didactic presentation. Given the current gap between guidelines and practice, our results emphasize the need for a formal medical school and residency-based curriculum related to preoperative patient evaluation.
Language	English
Publishing date	2023-09-25
Publishing country	United States
Document type	Journal Article
ISSN	1948-2035
ISSN	1948-2035
DOI	10.17161/kjm.vol16.20986
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Article: The Role of Preoperative Evaluations in Otorhinolaryngological Procedures.

Adegbiji, Waheed Atilade / Olajide, Gabriel Toye / Olatoke, Fatai / Ogundipe, Olubunmi Kolawole / Alabi, Sulyman Biodun

Nigerian medical journal : journal of the Nigeria Medical Association

2019 Volume 59, Issue 6, Page(s) 59–63

Abstract: ... surgery, associated comorbidity and abnormal laboratory investigation results in ear, nose, and throat ... arterial hypertension and 6.8% diabetes mellitus. The types of surgery in the patients were 14.6% ear surgery, 12.3 ... nasal surgery, and 59.2% throat surgery. Delayed surgery occurred in 25.5% of the patients. The most common ...

Abstract	Background: Routine laboratory investigations are important in preoperative preparation of otorhinolaryngological, head and neck patients to assess and to prevent operative risks. This study aimed at determining the American Society of Anesthesiologist (ASA) classification of the preoperative patients, causes of delayed surgery, associated comorbidity and abnormal laboratory investigation results in ear, nose, and throat surgical practice in a low-resource setting. Materials and methods: This is a prospective hospital-based study of patients being worked up for elective surgical procedures in Ekiti State University Teaching Hospital, Nigeria, from January 2014 to December 2016. Patients that gave consent were enrolled into the study. Interviewer-assisted questionnaires were used to obtained data from the patients. Data obtained were collated and statistically analyzed by using SPSS version 16. Results: A total of 424 patients were enrolled into the study. Males constituted 61.8% and male to female ratio was 2:1. Majority, i.e. 69.8% of the patients belonged to the ASA Grade I. Preoperative findings leading to delayed surgery occurred in 17.9% of the patients. They were due to 2.4% arterial hypertension and 6.4% delayed routine laboratory investigations results. The overall comorbid illness was 21.2%. Major comorbid illnesses were 2.4% arterial hypertension and 6.8% diabetes mellitus. The types of surgery in the patients were 14.6% ear surgery, 12.3% nasal surgery, and 59.2% throat surgery. Delayed surgery occurred in 25.5% of the patients. The most common findings were 6.8% anemia, 6.3% abnormal prothrombin/international normalized ratio, and 5.7% blood electrolyte and urea. Conclusion: All surgical conditions are peculiar with different comorbid illnesses which can lead to untoward outcome. Adequate preoperative evaluation and preoperative laboratory investigation of ear, nose, and throat conditions are mandatory to detect subclinical illnesses in poor-resource setting.
Language	English
Publishing date	2019-08-17
Publishing country	Nigeria
Document type	Journal Article
ZDB-ID	424429-1
ISSN	0300-1652
ISSN	0300-1652
DOI	10.4103/nmj.NMJ_183_17
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Article ; Online: Preoperative and Perioperative Management of Diabetics Undergoing Elective Foot and Ankle Surgery.

McGregor, Patrick Cole / LeDuc, Ryan

The Orthopedic clinics of North America

2023 Volume 54, Issue 3, Page(s) 341–348

Abstract: ... anesthesiologists, ensures diabetic patients receive comprehensive evaluation before elective surgery. Orthopedic ... Proper preparation and management of modifiable risk factors can optimize outcomes in diabetics ... A multidisciplinary approach to preoperative optimization, including surgeons, primary care providers, and ...

Abstract	Diabetics are a highly comorbid population with an elevated risk profile when undergoing surgery. Proper preparation and management of modifiable risk factors can optimize outcomes in diabetics. A multidisciplinary approach to preoperative optimization, including surgeons, primary care providers, and anesthesiologists, ensures diabetic patients receive comprehensive evaluation before elective surgery. Orthopedic surgeons must understand preoperative optimization goals as they pertain to nutrition, glycemic control, and cardiovascular disease in diabetic patients.
MeSH term(s)	Humans ; Ankle/surgery ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/etiology ; Diabetes Mellitus/surgery ; Risk Factors ; Elective Surgical Procedures/adverse effects ; Comorbidity
Language	English
Publishing date	2023-03-23
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	417389-2
ISSN	1558-1373 ; 0030-5898
ISSN (online)	1558-1373
ISSN	0030-5898
DOI	10.1016/j.ocl.2023.02.006
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Article ; Online: Standards of perioperative management in total knee and hip arthroplasty procedures. A survey-based study. Part I: Preoperative management.

Pabjańczyk, Izabela / Owczuk, Radosław / Kutaj-Wąsikowska, Halina / Fronczek, Jakub / Węgrzyn, Krzysztof / Jasińska, Monika / Jarocki, Paweł / Mudyna, Wojciech / Mastalerz-Migas, Agnieszka / Pilecki, Zbigniew / Czubak, Jarosław / Marczyński, Wojciech Józef / Nowak, Sebastian / Czuczwar, Mirosław / Szczeklik, Wojciech

Anaesthesiology intensive therapy

2023 Volume 55, Issue 4, Page(s) 262–271

Abstract: ... before surgery. For example, 47% of orthopaedists and 20% of anaesthesiologists order urinalysis, while 53 ... and orthopaedists were prepared to gain insight into the preparation of patients for TKA and THA ... of orthopaedists and preoperative rehabilitation is prescribed by 46% of them. A total of 56% surveyed ...

Abstract	Introduction: Recent years have seen an increasing number of elective total knee (TKA) and hip arthroplasty (THA) procedures. Since a wide variety of methods and procedures are used in perioperative management, a survey-based study was carried out to identify the patterns of practice in Polish hospitals. Material and methods: With the help of the LimeSurvey application, questionnaires for anaesthesio-logists and orthopaedists were prepared to gain insight into the preparation of patients for TKA and THA procedures and perioperative care. Questionnaires included both single and multiple-choice questions concerning among other things type of laboratory tests, additional examinations and consultations performed on a routine basis before elective TKA and THA procedures. Results: A total of 162 medical centres took part in the study. Questionnaire responses were obtained from 93 (57%) orthopaedics teams and 112 (69%) anaesthesiology teams. A mean (standard deviation, SD) of 7.2 (3.5) laboratory tests are routinely ordered before surgery. For example, 47% of orthopaedists and 20% of anaesthesiologists order urinalysis, while 53% of orthopaedists and 26% of anaesthesiologists order a CRP test. Seventy-nine per cent of orthopaedists refer patients for at least one specialist consultation before the procedure. Dental consultation is requested by 40%, gynaecological consultation by 27%. Patient preoperative education is provided by 85% of orthopaedists and preoperative rehabilitation is prescribed by 46% of them. A total of 56% surveyed anaesthesiologists perform pre-anaesthetic evaluation upon patients' hospital admission. Conclusions: The study found that the number of examinations and specialist consultations conducted in Polish hospitals exceeded the scope of recommendations of scientific societies. Furthermore, the authors identified a need to standardise perioperative management in the form of Polish guidelines or recommendations, with the intention to improve patient safety and optimize health care expenses.
MeSH term(s)	Humans ; Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee ; Surveys and Questionnaires
Language	English
Publishing date	2023-12-12
Publishing country	Poland
Document type	Journal Article
ISSN	1731-2531
ISSN (online)	1731-2531
DOI	10.5114/ait.2023.132832
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Article ; Online: Pro-Con Debate: Anesthesiologist- Versus Hospitalist- Run Preoperative Clinics and Perioperative Care.

Hepner, David / Harrop, Catriona M / Whinney, Christopher / Gulur, Padma

Anesthesia and analgesia

2022 Volume 134, Issue 3, Page(s) 466–474

Abstract: ... The medical and anesthesia evaluation before surgery has pivoted from the model of "clearance" to the model ... surgery. This article hopes to shed light on this debate with the data and perspectives on these care ... of preoperative clinics run by anesthesiologists versus hospitalists and their role in perioperative care ...

Abstract	In this Pro-Con commentary article, we discuss the models, value propositions, and opportunities of preoperative clinics run by anesthesiologists versus hospitalists and their role in perioperative care. The medical and anesthesia evaluation before surgery has pivoted from the model of "clearance" to the model of risk assessment, preparation, and optimization of medical and psychosocial risk factors. Assessment of these risk factors, optimization, and care coordination in the preoperative period has expanded the roles of anesthesiologists and hospitalists as members of the perioperative care team. There is ongoing debate regarding which model of preoperative assessment provides the most optimal preparation for the patient undergoing surgery. This article hopes to shed light on this debate with the data and perspectives on these care models.
MeSH term(s)	Anesthesiologists ; Hospital Administration ; Hospitalists ; Humans ; Perioperative Care/methods ; Perioperative Care/trends ; Preoperative Care/methods ; Preoperative Care/trends ; Risk Assessment ; Surgical Procedures, Operative
Language	English
Publishing date	2022-02-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	80032-6
ISSN	1526-7598 ; 0003-2999
ISSN (online)	1526-7598
ISSN	0003-2999
DOI	10.1213/ANE.0000000000005877
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Zs.MO 149: Show issues

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Article: Preoperative anesthetic evaluation and preparation in patients requiring esophageal surgery for cancer.

Congedo, Elisabetta / Aceto, Paola / Petrucci, Rosanna / Mascia, Antonio / Gualtieri, Elisabetta / De Cosmo, Germano

Rays

2005 Volume 30, Issue 4, Page(s) 341–345

Abstract: ... of surgical risk, preoperative performance status, particularly with regard to pulmonary and cardiac risk, is ... American Heart Association guidelines. With the identification of risk factors, patients undergoing esophageal surgery ... respiratory status. Thorough preoperative evaluation is essential for assessing the operative risk ...

Abstract	Esophagectomy for carcinoma of the esophagus is associated with significant mortality and morbidity. Patients with esophageal cancer have frequently obstruction with dysphagia and they often develop malnutrition. In addition, patients can suffer from chronic aspiration leading to a poor preoperative respiratory status. Thorough preoperative evaluation is essential for assessing the operative risk in the individual patient. Respiratory and cardiac problems are the most common complications and assessment of surgical risk, preoperative performance status, particularly with regard to pulmonary and cardiac risk, is likely to be the most important factor. Clinical findings are more predictive of pulmonary complications than results of testing. Cardiac risk is evaluated according to the American College of Cardiology (ACC)/American Heart Association guidelines. With the identification of risk factors, patients undergoing esophageal surgery could be stratified. Appropriate preoperative risk-reduction strategies can be used to decrease morbidity and mortality rates associated with esophagectomy for cancer.
MeSH term(s)	Anesthesia/methods ; Esophageal Neoplasms/surgery ; Esophagectomy ; Humans ; Postoperative Complications/prevention & control ; Preoperative Care/methods ; Risk Assessment
Language	English
Publishing date	2005-10
Publishing country	Italy
Document type	Journal Article ; Review
ZDB-ID	433401-2
ISSN	0390-7740
ISSN	0390-7740
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Article: Anesthetic management of a patient with preoperative R-on-T phenomenon undergoing laparoscopic-assisted sigmoid colon resection: A case report.

Li, Xiao-Xi / Yao, Yun-Feng / Tan, Hong-Yu

World journal of clinical cases

2022 Volume 11, Issue 9, Page(s) 2098–2103

Abstract: ... out preoperatively under consultation with a cardiovascular specialist, and surgery was uneventfully ... monitoring in a patient diagnosed with sigmoid colon cancer. Careful evaluation and treatment with mexiletine were carried ... performed under general anesthesia after thorough preparation.: Conclusion: Physicians should be vigilant ...

Abstract	Background: The R-on-T phenomenon is a malignant arrhythmia associated with potentially catastrophic consequences. It may initiate ventricular tachycardia or ventricular fibrillation, which can result in syncope or sudden cardiac death. This manifestation poses a great challenge for anesthesiologists. However, it is rarely encountered in the perioperative setting. Case summary: We herein present a case in which the R-on-T phenomenon was incidentally revealed by 24-h Holter monitoring in a patient diagnosed with sigmoid colon cancer. Careful evaluation and treatment with mexiletine were carried out preoperatively under consultation with a cardiovascular specialist, and surgery was uneventfully performed under general anesthesia after thorough preparation. Conclusion: Physicians should be vigilant about this infrequent but potentially fatal arrhythmia. Our experience suggests that the anesthetic process can be greatly optimized with careful preparation.
Language	English
Publishing date	2022-12-22
Publishing country	United States
Document type	Case Reports
ISSN	2307-8960
ISSN	2307-8960
DOI	10.12998/wjcc.v11.i9.2098
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