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Part 2. Preparing for Anesthesia
Section A. Approach to the Anesthesia Patient
Chapter 4. Overview of Preoperative Assessment and Management
Bobbie Jean Sweitzer, MD
1. Comprehensive preoperative evaluation and management improves patient satisfaction, outcomes, and safety.
2. Inadequate preoperative evaluation and management increase perioperative adverse events.
3. At a minimum, the preanesthesia visit should include an interview with the patient to review the medical history (including medications, allergies, comorbid conditions, and previous operations), an appropriate physical examination, review of diagnostic data, assignment of an American Society of Anesthesiologists physical status score, and a formulation and discussion of the planned anesthetic with the patient.
4. The medical history is the most important component of preoperative assessment.
5. Findings from the history and physical examination determine the need for further diagnostic testing.
6. Diagnostic tests should only be ordered if the results will alter the planned anesthetic or procedure or establish an already suspected diagnosis. "Screening" tests are never appropriate.
7. A determination of functional capacity or the patient's cardiorespiratory fitness can guide further testing and predict a wide range of complications and outcome.
8. Cardiovascular morbidity and mortality are the..."
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