Significant Concerns
There will be occasions when either a surgeon or a healthcare giver will recognize significant problems with your medical condition that may be of concern. In this case, an Anesthesia Consultation may be requested days before surgery. The intent is to determine if your condition will require cancellation of the surgery or if there will are special techniques required during the surgery to keep you safe. This evaluation will allow your healthcare team to identify the problems faced at the time of surgery and adequately prepare for your arrival. This is one of the most important steps you can take to make your surgery a success.
A consulting anesthesiologist or anesthesia provider will provide a preoperative anesthesia consultation before major surgery. The consultant is usually an individual with advanced training.
This presents an opportunity to better document comorbid illness, optimize medical conditions, facilitate referrals to specialists, order specialized investigations, initiate interventions to decrease risk, discuss aspects of perioperative care, and arrange appropriate postoperative care.
One goal of this review is to discuss the implications of recent studies that have been performed and determine if a special anesthetic approach must be taken for the safety of the patient. Sometimes a special type of anesthesia will be required or in extreme cases the case may have to be rescheduled.
Some of the medical situations that may require special considerations for surgery and must be discussed carefully with the anesthesia consultant. These are usually situations that could result in bad outcomes if they are not addressed before the event.
Some of the conditions that may come up are a history of a difficult intubation, Jehovah’s Witness requirements, history of malignant hypertension, history of myopathy or pseudo cholinesterase deficiency among many others. These problems are particular to anesthesia and how it is given. They all require very specific procedures to ensure you are getting the best of care. The anesthesia provider will evaluate and determine if special techniques are necessary for surgery.
Some of the more common conditions that will require an anesthesia consultation are as follows:
- Heart Disease
- Kidney Disease
- Previous stroke
- Complications with anesthesia
- Lung Disease such as emphysema or asthma
It is important to address these medical conditions, so the anesthesia team is well prepared to give you the best of care and there is no delay on the day of surgery.
On the day of your surgery the patient will have one last evaluation by the anesthesia team prior to the procedure. This is performed in the preoperative area the day of the surgery, which is one of the reasons why they want you to arrive early.
This gives the anesthesia team the opportunity to discuss your medical history for any new information. They will also have the opportunity to review any other previous examinations such as the History and Physical exam from your doctor’s office, the recent anesthesia consultation, a specialist’s evaluation and any laboratory tests or x-rays performed during the evaluation.
This evaluation is offered to all patients as a precaution to ensure there is no problem that would affect the surgery.
