Important Factors in the Patient's Pre-Op History

What are the important aspects of the preoperative evaluation?

This is the time when the anesthesiologist will take the patient's history, review the current drug therapy and perform the physical exam. The preoperative history will focus on review of organ system function, coexisting diseases, previous adverse effects of anesthesiology The anesthesiologist will inform the physician of the events expected on the day of surgery, will discuss the plan for anesthesiology and will obtain informed consent.

What are questions to ask to investigate previous adverse responses to anesthesia?

1) Have you ever had any allergic reactions?

2) Any prolonged paralysis?

3) Any delayed awakening?

4) Any nausea or vomiting?

5) Any hoarseness?

6) Any myalgia?

7) Any hemorrhage?

8) Jaundice?

9) Post-spinal headache?

10) Have your relatives ever had any adverse reactions?

Important organ-specific questions for the review of systems

1) Cardiovascular

a. Exercise tolerance

b. Angina

c. Prior myocardial infarction

d. Hypertension

e. Rheumatic fever

f. Claudication

g. Tachyarrythmias

2) Pulmonary

a. Dyspnea and orthopnea

b. Coughing/Sputum production

c. Asthma

d. Cigarette consumption

e. Pneumonia

f. Recent URI

3) Hepatic

a. Ethanol consumption

b. Hepatitis

4) Renal

a. Nocturia

b. Pyuria

5) Skeletal/Muscular

a. Arthritis

b. Osteoporosis

c. Weakness

6) Endocrine

a. Diabetes

b. Thyroid gland dysfunction

c. Adrenal gland dysfunction

7) Coagulation

a. Bleeding tendency

b. Easy bruising

c. Hereditary coagulopathies

8) Reproductive system

a. Menstrual history

b. Sexually transmitted disease