Anaesthetic assessment and preparation for surgery

The nature of anaesthetists’ training and experience makes them uniquely qualifi ed to assess the inherent risks of giving an anaesthetic. Ideally, every patient should be seen by an anaesthetist prior to surgery in order to identify, manage, and minimize these risks. Traditionally, this occurred when the patient was admitted, usually the day before an elective surgical procedure. However, if at this time the patient was found to have any signifi cant co-morbidity, surgery was often postponed, and with no time to admit a different patient operating time was wasted. Recently, in an attempt to improve effi ciency, there has been a move towards admitting a patient on the day of their planned surgical procedure. This makes the situation even more diffi cult by further reducing the opportunity for an adequate anaesthetic assessment. This has led to signifi cant changes in the preoperative management of patients undergoing elective surgery, including the introduction of clinics specifi cally for anaesthetic assessment. A variety of models of ‘preoperative’ or ‘anaesthetic assessment’ clinic exist; the following is intended to outline their principle functions. Those who require greater detail are advised to consult the document produced by the Association of Anaesthetists of Great Britain and Ireland (AAGBI) (see Useful websites). The preoperative assessment clinic