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Evaluating the Patient Before Anesthesia PENG Shuling Second Affiliated Hospital Sun Yat-sen University What is anesthesia? Anesthesiology definition The management of procedures for rendering a patient insensible to pain and emotional stress during surgical, obstetrical, and certain medical procedures. The support of life functions under the stress of anesthesia and surgical manipulations. Anesthesiology Clinical anesthesia Pain management First-aid and resuscitation Intensive care Anesthesiology Classification General anesthesia: A. Inhalation anesthesia B. Intravenous anesthesia ( intramuscular ) Regional anesthesia: spinal (subarachnoid) block epidural block (caudal block) nerve (brachial) plexus block local infiltration Others Deliberate hypotension Deliberate hypothermia Acute normovolemic hemodilution Anesthesia procedures Preoperative evaluation and premedication 2. Anesthesia induction 3. Anesthesia maintenance 4. Anesthesia termination 5. Recovery period Why should we perform a preoperative evaluation? Basic effects of anesthesia on the body Depression on ascending reticular activating system Depression on medullar ( Res. and Cardiovas. center ) The purposes and procedures of the preoperative visit(evaluation) Establish rapport with the patient. Obtain a history and perform a physical examination. Assess the risks of anesthesia and surgery. To reduce perioperative morbidity and mortality. Institute preoperative management. Order investigations and prescribe premedication. Obtaining informed consent . History. Present surgical illness, presumptive diagnosis, initial treatment, and responses. Coexisting medical illnesses. Medications. Allergies and drug reactions. Anesthetic and surgical history. Social history and habits. Smoking,
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