3 Pre-operative screening for elective surgery

The primary goal of pre-operative evaluation is to assess adequately the patient's preoperative condition and to diagnose and possibly to treat disturbances and diseases which may be of relevance to the course of anaesthesia, surgery and the post-operative period. A pertinent medical history and a physical examination by an experienced anaesthetist are compulsory. A minimal set of tests should be carried out in all patients. The results obtained from these tests were very abnormal in a variety of studies; the information was not always apparent from the history and the examination although it was of relevance to anaesthesia and the post-operative period. Further laboratory tests such as haematocrit and blood glucose and potassium (K⁺) concentrations should only be ordered if indicated on the basis of the history and the examination. This small set of tests seems to be justified for the following reasons:• to identify unexpected risk factors not apparent from the history and the examination;

1. • to avoid additional costs resulting from deferring a case due to incomplete tests;

2. • to avoid medicolegal consequences of a possibly incomplete pre-operative evaluation;

3. • to protect patients from unnecessary invasive investigations.