Anesthesia Evaluation Health Article

Definition

Anesthesia evaluation refers to the series of interviews, physical examinations, and laboratory tests that are generally used in North America and western Europe to assess the general fitness of patients scheduled for surgery and to determine the need for special precautions or additional testing. There is no universally accepted definition of anesthesia evaluation as of 2003; however, the Task Force on Preanesthesia Evaluation of the American Society of Anesthesiologists (ASA) has tentatively defined it as "....the process of clinical assessment that precedes the delivery of anesthesia care for surgery and for non-surgical procedures." Anesthesia evaluation is usually discussed in the context of elective or scheduled surgical procedures rather than emergency surgery.

Anesthesia evaluation is a relatively recent development in preoperative patient care. Prior to the 1970s, anesthesiologists were often given only brief notes or outlines of the patient's history and physical examination written by the operating surgeon or the patient's internist. This approach became increasingly unsatisfactory as the practice of anesthesiology became more complex. In the last four decades, the introduction of new anesthetics and other medications, laser-assisted surgical procedures, increasingly sophisticated monitoring equipment, and new discoveries in molecular biochemistry and genetics have made the anesthesiologist's role more demanding. During the 1980s and 1990s, some departments of anesthesiology in large urban medical centers and major university teaching hospitals began to set up separate clinics for anesthesia evaluation in order to improve the assessment of patients before surgery.

Purpose

Anesthesia evaluation has several different purposes. The information that is obtained during the evaluation may be used to:

• Guide the selection of anesthetics and other medications to be used during surgery.
• Plan for the patient's postoperative recovery and pain management.
• Educate the patient about the operation itself, the possible outcomes, and self-care during recovery at home.
• Determine the need for additional staff during or after surgery.
• Minimize confusion caused by rescheduling operations because of last-minute discoveries about patients' health.
• Improve patient safety and quality of care by collecting data for later review and analysis. The ASA has noted that few controlled trials of different approaches to anesthesia evaluation have been conducted as of 2003, and that further research is needed.