Preoperative considerations

Abstract

This new chapter gives an overview of the management principles at the start of a patient’s perioperative journey. It includes preoperative assessment with detail on history, examination, investigations, consultation models, functional assessment (including CPET), risk assessment, outcomes, shared-decision making and consent. It also outlines preoptimisation with a focus on prehabilitation and lifestyle modifications. It gives up-to-date information on fasting, VTE prophylaxis, antibiotic prophylaxis, anaemia and iron deficiency, the perioperative management of patients’ usual medications and herbal medicines, and the use of premedicants. Finally, it outlines the principles of enhanced recovery and emphasizes the importance of postoperative planning.