Pre-Operative Assessment Components Explained

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The pre-operative assessment offers doctors a chance to identify co-morbidities that may lead to complications during the anesthetic, surgical, and post-surgery period. If you are undergoing elective surgery, the surgeon will require you to go for pre-operative assessment 2 or 4 weeks before surgery.

What Are the Significant Components of Pre-Operative Assessment?

The major components include:

• Pre-Operative History

The goal of pre-operative assessment is to identify cardiac conditions and other diseases that might put the patient at high risk of complications before, during, and after surgery.

The doctor will explore a brief history of why you first attended surgery and what procedures you have been scheduled for.

• Medical History

The doctor will ask you or your confidant of your full medical history. He or she will specifically ask about:

• Cardiovascular diseases including hypertension. Conditions that affect the cardiovascular system pose a great risk during anesthesia
• Respiratory diseases since adequate oxygen and ventilation prevent acute ischemic events during the surgery
• Renal diseases since they can increase the risk of complications during surgery
• Endocrine conditions such as diabetes mellitus and thyroid disease

The other specific questions the doctor can ask are about your pregnancy for females in their reproductive age and sickle cell anemia especially people of African or Afro-Caribbean descent.

• Past Surgical History

The doctor will ask if the patient has been in a previous surgical operation, why, and when they had it.

• Anesthetic History

Your doctor will require your past anesthetic history. Have you had anesthesia before? If so, did you experience any issues? Did you experience vomiting or nausea as a result of anesthesia?

• Family History

Your specialist might ask you if any of your family members has malignant hyperpyrexia. Malignant hyperpyrexia is a condition whereby, your body undergoes muscle rigidity and temperature rises. This condition can pose a risk during surgery.

• Social History

Before proceeding with surgery, your doctor will ask about your drinking and smoking history. He or she might ask about your tolerance to exercise.

• Drug History

Your specialist will require your full drug history since you will need to stop using certain drugs before surgery.

The other components of the pre-op evaluation are:

• Physical Examination

During a physical exam, your doctor will focus on your overall fitness and signs of systemic diseases. He or she shall consider the following:

• Vital signs
• Arrhythmia, cardiac murmur, and fluid status
• Breathes
• Abdominal masses
• Signs of infections

If relevant the specialist will also examine the area of operation. The anesthetist will also perform an airway exam before the anesthesia.

• Pre-Operative Investigations

The nature of the investigation depends on age, co-morbidities, and nature of the pre-op surgery procedure. Some of the investigations include:

• Blood Tests

Your specialist can carry different blood tests include:

• Full blood count to check for anemia or thrombocytopenia since they require reversal to prevent cardiovascular events
• Liver functions test to check the metabolism and synthesis function since they are significant in peri-
• operative management
• Electrolytes and urea to assess the baseline of renal function
• Clotting screen to prevent excessive during and after surgery

• Imaging Tests

Some of the tests that your specialist can perform before surgery are:

• Electrocardiogram for patients with a history of cardiovascular conditions and those undergoing major surgery
• Chest x-ray to check for any respiratory illnesses and significant smoking history

If your specialist detects signs of chronic lung condition, he or she might use spirometry to assess the baseline of the current condition and predict postoperative complications.

Your specialist might also carry out other tests including:

• Pregnancy test with patient’s consent
• Sickle cell test
• Urinalysis, if there are signs of underlying glycosuria

• Airway Examination

An anesthetist carries out the examination. He or she looks at the face for any facial abnormalities that might cause difficulties during airway insertion.

The specialist will ask you to open your mouth to assess:

• The degree that your mouth opens
• State of your teeth
• Your oropharynx by asking you to protrude your tongue

The last step involves assessing the neck. He or she might ask you to flex or extend your neck. The anesthetist can also ask you to maximally extend your neck and measure the distance between the thyroid cartilage and your chin.

Primary Health Care

Do you need primary health care in Germantown, MD? Dr. Lakhvinder Wadha is a doctor at Germantown Primary Health care that receives patients for minor and comprehensive treatments such a surgery.