PREPARATION
,Pre-anesthetic assessment
The goals are
To reduce the anxiety and educate the patient about
anesthesia.
To obtain information about patient's medical history.
To perform physical examination.
To determine which tests are required.
To plan anesthetic technique.
To obtain informed consent.
To give preoperative instructions.
,Pre-anesthetic assessment
Preoperative evaluation is done with:
1. History
Any medical illness in past/present.
History of allergy to any drug.
History of medications.
History of previous anesthesia.
History of personal habits (smoking, alcoholism or
drug abuse).
, Pre-anesthetic assessment
2. Physical Examination
General physical examination (including pulse and blood pressure).
Systemic examination of cardiovascular system, respiratory system,
hepatic system, nervous system, abdomen and spine.
In respiratory system examination, other than routine assessment
Breath-holding time should be assessed in every patient. Patient is
asked to hold the breath after full inspiration. Normal is more than
25 seconds. 15-25 seconds is borderline. Less than 15 seconds
indicate severely diminished cardiorespiratory reserve.
Airway assessment to rule out difficult airway. It is one of the most
important assessments for anesthesiologist. It includes assessment of
mouth opening, denture status and neck movements. Out of the many
parameters used for airway assessment Mallampati grading,
Thyromental distance and neck movements are assessed in every
case