Preanesteshia evaluation (article)

SPECIAL ARTICLE
Anesthesiology 2002; 96:485–96 © 2002 American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins, Inc.

Practice Advisory for Preanesthesia Evaluation
A Report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation
PRACTICE advisories are systematically developed reports that are intended to assist decision-making in areas ofpatient care where scientific evidence is insufficient to develop an evidence-based model. Practice advisories provide a synthesis of opinion from experts, open forums, and other public sources. Practice advisories report the current state of scientific literature, but are not supported by literature to the same degree as standards or guidelines due to the lack of sufficient numbers of adequately controlledstudies. Advisories are not intended as guidelines, standards, or absolute requirements. The use of practice advisories cannot guarantee any specific outcome. They may be adopted, modified, or rejected according to clinical needs and constraints. Practice advisories are subject to periodic revision as warranted by the evolution of medical knowledge, technology, and practice. the patient’s medicalrecords, interview, physical examination, and findings from medical tests and evaluations. As part of the preanesthesia evaluation process, the anesthesiologist may choose to consult with other healthcare professionals to obtain information or services that are relevant to perioperative anesthetic care. Preoperative tests, as a component of the preanesthesia evaluation, may be indicated for variouspurposes, including but not limited to (1) discovery or identification of a disease or disorder that may affect perioperative anesthetic care, (2) verification or assessment of an already known disease, disorder, medical or alternative therapy that may affect perioperative anesthetic care, and (3) formulation of specific plans and alternatives for perioperative anesthetic care. For this Advisory,perioperative refers to the care surrounding operations and procedures. The assessments made in the process of a preanesthesia evaluation may be used to educate the patient, organize resources for perioperative care, and formulate plans for intraoperative care, postoperative recovery, and perioperative pain management.

Definition of Preanesthesia Evaluation
The literature does not provide astandard definition for preanesthesia evaluation. For this Practice Advisory, the preanesthesia evaluation is defined as the process of clinical assessment that precedes the delivery of anesthesia care for surgery and for nonsurgical procedures. The preanesthesia evaluation is the responsibility of the anesthesiologist. Preanesthesia evaluation consists of the consideration of information from multiplesources that may include

Purposes of the Advisory for Preanesthesia Evaluation
The purposes of this Advisory are to (1) assess the currently available evidence pertaining to the healthcare benefits of preanesthesia evaluation, (2) offer a reference framework for the conduct of preanesthesia evaluation by anesthesiologists, and (3) stimulate research strategies that can assess the healthcarebenefits of a preanesthesia evaluation.

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Developed by the Task Force on Preanesthesia Evaluation: L. Reuven Pasternak, M.D. (Chair), Baltimore, Maryland: James F.Arens, M.D., Houston, Texas; Robert A. Caplan, M.D., Seattle, Washington; Richard T. Connis, Ph.D., Woodinville, Washington; Lee A. Fleisher, M.D., Baltimore, Maryland; Richard Flowerdew, M.B., Portland, Maine; Barbara S. Gold, M.D., Minneapolis, Minnesota; James F. Mayhew, M.D., League City, Texas; David G. Nickinovich, Ph.D., Bellevue, Washington; Linda Jo Rice, M.D., St. Petersburg, Florida;...