An assessment performed before surgery in which the patient's overall health is reviewed from an anesthetic standpoint and a tailored anesthesia plan is drawn up. It includes ASA classification and airway evaluation.
Indication
- All surgical procedures planned under general, regional or sedation anesthesia
- Diagnostic procedures requiring anesthesia (endoscopy, MRI, biopsy)
- Risk assessment in patients with chronic conditions (heart, lung, kidney, diabetes)
- Planning for patients who experienced anesthesia complications in previous surgeries
- Special patient groups such as advanced age, pregnancy or severe obesity
- Rapid risk assessment before emergency surgery
Preparation
- A complete list of current medications and dosages is brought
- Herbal products and supplements are reported
- Reports of previous surgeries and anesthesia are provided
- Prior heart, pulmonary tests and blood work are kept ready if available
- Known allergies (medication, latex, food) are communicated in writing
How it's performed
- The anesthesiologist obtains a detailed medical history (prior illnesses, medications, allergies)
- Physical examination is performed; heart, lungs and airway (mouth opening, neck mobility) are evaluated
- ASA physical status classification (1-4) is assigned and overall anesthesia risk is determined
- Mallampati score is used to assess the likelihood of difficult intubation
- Additional tests are ordered when needed: ECG, chest X-ray, blood work
- The anesthesia method (general, regional, sedation) is decided together with the patient and informed consent is obtained
Post-procedure
- The anesthesia plan is shared with the surgical team
- Required medication changes (such as discontinuation of blood thinners) are given to the patient in writing
- Fasting duration and which medications to take on the morning of surgery are explained
- In high-risk patients, additional consultations (cardiology, pulmonology) are arranged
Risks
- Unexpected reactions during surgery due to undisclosed medications or illnesses
- Surgery may need to be postponed in high-risk patients
- Additional tests or consultations may extend the surgical timeline
- The planned anesthesia type may need to be changed based on evaluation findings
FAQ
When should this evaluation be performed?
Preferably at least 1-2 weeks before elective surgery; this allows time to complete additional tests and consultations.
Which tests are usually requested?
Depending on the patient's age and comorbidities, complete blood count, biochemistry, ECG and, if needed, a chest X-ray may be requested.
Should I stop my blood thinners?
The anesthesiologist makes this decision. The withdrawal period varies depending on the medication and the urgency of the surgery; do not stop them on your own.
I have a cold — will the surgery be postponed?
If there is an active respiratory infection, elective surgeries may be postponed because of the increased anesthetic risk.
Related Information
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Exercise stress test — evaluation of electrocardiographic changes under increased cardiac workload during exertion.
Spinal anesthesia
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Spinal anesthesia — a regional anesthesia technique applied through the lower back to numb the lower half of the body.
Epidural Anesthesia
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Epidural anesthesia — placement of a catheter into the epidural space in the lower back to provide long-lasting pain control.
Sedation
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Conscious sedation — an anesthesia method using calming and pain-relieving medications without complete loss of consciousness.
Local Anesthesia
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Local anesthesia — a superficial anesthesia method in which only a small area of skin where the procedure will be performed is numbed.
Regional anesthesia
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Regional anesthesia — numbing of a specific body region using a nerve block.