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Patient Assessment

The overall aim of patient assessment is to ensure that surgery is justified and that the risks to the patient from the procedure are minimised, especially in patients at high risk of surgical complications. Therefore, one of the most important considerations prior to surgery is the disposition of the patient. This will determine the pre-operative precautions and medication required, as well as the choice of anaesthetic and operative technique. These decisions can be made in collaboration with the patient’s primary care physician, or within specialist pre-operative assessment clinics. Information resources such as postoperative pain guidelines may be useful: (Rosenquist 2003)

The approach to optimising pre-operative patient health prior to surgery varies between surgical procedure and between different hospitals, but some basic principles apply to all patients undergoing surgery:

The decision about which anaesthetic technique to use for an individual patient is based on a formal review of their overall medical condition and any medication that they are taking. General, epidural and spinal anaesthesia, and combinations of these, have separate risks and benefits, which vary according to the patient’s co-morbidity and medications. Other factors such as surgical and anaesthetic experience and practice, local ward or institutional protocols for postoperative pain relief and patient mobilisation will also influence the choice of anaesthetic technique.

In addition to the choice of anaesthetic, there are also some general surgical considerations: