Perioperative assessment

Preoperative evaluation is the overall

assessment of the patients health to identify
operative risk that may influence recovery
period

 The primary role of preoperative evaluation

is to make a preoperative plan.
It is to assess the medical problems in
surgical patients.

 To determine how best to manage these

problems during surgery and
To provide recommendation for post
operative care.

 Preoperative risk assessment starts by

identifying the type of surgery to be
performed and
The type of patient who is to have it.

 An anaesthetic plan should be formulated

that will optimally accommodate the
patients baseline physiological state,
including any medical condition, previous
operations, the planned procedure, drug
sensitivities, previous anaesthetic
experiences and psychological makeup.

 To be valuable, performing a preoperative

test implies that a perioperative risk exists
when the results are abnormal and a
reduced risk exisot when the abnormality is
corrected.

 The assessment must include pertinent

history(including the review of medical
records)
Detailed Physical examination
& necessary laboratory investigations

History

-Patients problem as well as planned surgical

and diagnostic procedure must be established.
-underlying medical conditions- severity,
current and prior treatment
-drug history- including allergy and herbal
preparation.
-cigarette, alcohol and illicit drug use.
-previous anaesthetic history.

Physical examination
Physical examination should be tailored to the
specifics of a patients medical history and
presenting complaints (if any).
The role of preoperative physical examination
is to identify conditions that increase operative
risk.

 The following components are assessed:

Vital signs including blood pressure in both
arms
Carotid pulse, contour and bruit
Jugular venous pressure
Auscultation of the lungs
Precordial auscultation and palpation
Abdominal palpation

 Examination of the lower extremities for

edema
Characterization of peripheral pulses