Preoperative Evaluation (Night Before Surgery)

A patient undergoes 3 phases of care, which we call the perioperative phase, for surgery; phases in which anesthesia providers are intimately involved. These phases are:

(1) Preoperative phase
(2) Intraoperative phase
(3) Postoperative phase

As a nurse anesthetist, the night before I am scheduled to work in the OR, I am assigned to a room with surgical cases. The night before they are scheduled to have surgery, I have to perform a preoperative evaluation on each of my patients. The premise behind a preoperative evaluation is for me to get an idea on the patient’s past medical and surgical history and to determine whether this patient’s condition is optimized for surgery. If the patient is missing a simple lab test or an electrocardiogram, I can order that test to be performed the day of the surgery and depending on the result, the procedure can either continue as scheduled, be delayed, or cancelled. If the patient requires a more extensive workup (such as an echocardiogram or cardiac stress test) that requires the input of a specialist or the patient’s primary care physician, then more than likely, the case will be delayed until that patient has undergone the appropriate evaluation.

Basically, the goal of the preoperative evaluation is to determine whether it is safe for the patient to proceed with surgery. If not, then they need to undergo additional testing and evaluation by the appropriate physician in order to be cleared for surgery.