The day will come when you or a loved one will require surgery and an anesthetic. This is never an issue to be taken lightly as the world of medicine has learned the hard way. In the early years of surgery and anesthesia the mortality was high such that surgery and anesthesia had a terrible reputation. I want to include anesthesia and surgery together as the risks often are inseparable. Over the years of countless tragic experiences, the profession of medicine has learned how to limit these risks.
One of the key elements of this improvement is the pre-operative evaluation. This process allows the collection of key data about an individual to identify any problems or risk factors that might lead to a bad outcome during surgery. By dealing with these issues before surgery the risk to the patient is greatly reduced. This works well if the professional performing the evaluation is attentive and knowledgeable of peri-operative risks. It is in the patient’s best interest to seek the advice of an experienced professional.
If you have significant medical conditions such as lung or heart disease it is wise to look for the help of an individual who is familiar with these conditions and the dangers of surgery. If you are already seeing a cardiologist or pulmonologist by all means see them for your preoperative evaluation.
A preoperative evaluation consists at a minimum of a history and physical exam in the professional’s office. In addition, they may require additional studies such as an electrocardiogram (EKG) or chest x-ray. There may even be more studies required such as a stress test or echocardiogram. It is beyond the scope of this chapter to give the rationale behind each study but we will deal with these individually in the future on our website. To say the least, the purpose of all these efforts is to identify any problem that might lead to complications and address these before surgery. If a significant problem is identified which cannot be resolved, the surgery may be cancelled.