Purpose
Anesthesia evaluation has several different purposes. The information that is obtained during the evaluation may be used to:
- Guide the selection of anesthetics and other medications to be used during surgery.
- Plan for the patient's postoperative recovery and pain management.
- Educate the patient about the operation itself, the possible outcomes, and self-care during recovery at home.
- Determine the need for additional staff during or after surgery.
- Minimize confusion caused by rescheduling operations because of last-minute discoveries about patients' health.
- Improve patient safety and quality of care by collecting data for later review and analysis. The ASA has noted that few controlled trials of different approaches to anesthesia evaluation have been conducted as of 2003, and that further research is needed.
Description
There are several parts or stages in a typical anesthesia evaluation. The evaluation itself may be done in the hospital where the operation is scheduled, or in a separate facility attached to the hospital. The timing of the evaluation is affected by two major variables: the invasiveness of the operation to be performed and the patient's overall physical condition. An invasive operation or procedure is one that requires the surgeon to insert a needle, catheter, or instrument into the body or a part of the body. Surgical procedures are classified as high, medium, or low in invasiveness. Procedures that involve opening the chest, abdomen, or skull are usually considered highly invasive. Examples of less invasive procedures would include
tooth extraction , most forms of cosmetic surgery, and operations on the hands and feet.
The patient's physical condition is classified according to the ASA's six-point system as follows:
- P1. Normal healthy patient.
- P2. Patient with mild systemic disease.
- P3. Patient with severe systemic disease.
- P4. Patient with severe systemic disease that is life-threatening.
- P5. Moribund (dying) patient who is not expected to survive without an operation.
- P6. Brain-dead patient whose organs are being removed for donation.
As of 2003, the ASA recommends that patients with severe disease be interviewed and have their physical examination before the day of surgery. Patients in good health or with mild systemic disease who are scheduled for a highly invasive procedure should also be interviewed and examined before the day of surgery. Patients in categories P1 and P2 who are scheduled for low- or medium-invasive procedures may be evaluated on the day of surgery or before it.
http://www.surgeryencyclopedia.com/A-Ce/Anesthesia-Evaluation.html#ixzz12cqRRiaE