Preoperative patient assessment

Before any operation a patient is entitled to an adequate assessment Such an assessment has four goals, to acquire the relevant information about the patient's state, to educate the patient, to diminish anxiety and to obtain informed consent from the patient for the proposed procedure. The assessment should determine the nature and extent of the relevant surgical pathology, the nature and extent of any disease which might affect the conduct of the operation and postoperative course and also any specific problems that might affect choice of anaesthesia and postoperative care. The essential components are to take an adequate history and to examine the patient. Ancillary investigations should be undertaken only to onfirm and assess the extent of concomitant disease and only exceptionally, where their costs can justify their benefits, should routine screening examinations be performed. Assessment is most efficiently performed early and may use data generated by the patient, the surgeon, a preoperative clinic or the traditional night before visit. Patients undergoing emergency surgery should be assessed using a similar system.