Preoperative care refers to health care provided before a surgical operation. Preoperative care aims to do whatever is right to increase the success of the surgery.
At some point before the operation, the healthcare provider will assess the fitness of the person to have surgery. This assessment should include whatever tests are indicated, but not include screening for conditions without an indication.
Immediately before surgery the person's body is prepared, perhaps by washing with an antiseptic, and if needed, their anxiety is addressed to make them comfortable.
At some point before surgery a health care provider conducts a preoperative assessment to verify that a person is fit and ready for the surgery.[1][2] For surgeries in which a person receives either general or local anesthesia, this assessment may be done either by a doctor or a nurse trained to do the assessment.[2] The available research does not give insight about any differences in outcomes depending on whether a doctor or nurse conducts this assessment.[2]
Addressing anxietyedit
Playing calming music to patients immediately before surgery has a beneficial effect in addressing anxiety about the surgery.[3]
Surgical site preparationedit
Hair removal at the location where the surgical incision is made is often done before the surgery.[4] Sufficient evidence does not exist to say that removing hair is a useful way to prevent infections.[4] When it is done immediately before surgery, the use of hair clippers might be preferable to shaving.[4]
Bathing with an antiseptic like chlorhexidine does not seem to affect incidence of complications after surgery.[5] However, washing the surgical site with chlorhexidine after surgery does seem helpful for preventing surgical site infection.[6]
Risksedit
Screening is a test to see whether a person has a disease, and screenings are often done before surgery. Screenings should happen when they are indicated and not otherwise as a matter of routine. Screenings which are done without indication carry the risks of having unnecessary health care.
Commonly overused screenings include the following:
Electrocardiograms (ECGs) are sometimes given before any kind of surgery as a matter of routine, but are unnecessary if a person does not have new and worrisome symptoms and if the surgery is minor. Eye surgery, for example, would not usually require an ECG.[7]
Cardiac imaging and cardiac stress tests are usually unnecessary for people who do not have a serious heart condition and who are having surgery unrelated to the heart.[8] People in the United States using government healthcare services are especially likely to have this procedure without indication.[9]
Chest x-rays are usually unnecessary for people under age 70 who are not having chest surgery and who do not have worrisome symptoms.[10]
Breathing tests are usually unnecessary for people who do not smoke, do not have respiratory disease, and who do not have symptoms.[11]
Among children who are at normal risk of pulmonary aspiration or vomiting during anaesthesia, there is no evidence showing that denying them oral liquids before surgery improves outcomes but there is evidence showing that giving liquids prevents anxiety.[12]
Recreational substance usersedit
Sometimes before a surgery a health care provider will recommend some health intervention to modify some risky behavior which is associated with complications from surgery.
Smoking cessation before surgery is likely to reduce the risk of complications from surgery.[13]
In circumstances in which a person's doctor advises them to avoid drinking alcohol before and after the surgery, but in which the person seems likely to drink anyway, intense interventions which direct a person to quit using alcohol have been proven to be helpful in reducing complications from surgery.[14]
^Webster, Joan; Osborne, Sonya; Webster, Joan (2012). Webster, Joan (ed.). "Preoperative bathing or showering with skin antiseptics to prevent surgical site infection" (PDF). Protocols (9): CD004985. doi:10.1002/14651858.CD004985.pub4. hdl:10072/51996. PMID 22972080.
^Dumville, Jo C; McFarlane, Emma; Edwards, Peggy; Lipp, Allyson; Holmes, Alexandra; Dumville, Jo C (2013). Dumville, Jo C (ed.). "Preoperative skin antiseptics for preventing surgical wound infections after clean surgery". Reviews (3): CD003949. doi:10.1002/14651858.CD003949.pub3. PMID 23543526.
^Oppedal, Kristian; Møller, Ann Merete; Pedersen, Bolette; Tønnesen, Hanne; Oppedal, Kristian (2012). "Preoperative alcohol cessation prior to elective surgery". Reviews (7): CD008343. doi:10.1002/14651858.CD008343.pub2. PMID 22786514.
External linksedit
Preoperative care in the Surgery Encyclopedia
January 01, 1970
preoperative, care, redirects, here, state, transgender, person, before, surgery, transsexual, surgical, status, refers, health, care, provided, before, surgical, operation, aims, whatever, right, increase, success, surgery, some, point, before, operation, hea. Pre op redirects here For the state of a transgender person before surgery see Transsexual Surgical status Preoperative care refers to health care provided before a surgical operation Preoperative care aims to do whatever is right to increase the success of the surgery At some point before the operation the healthcare provider will assess the fitness of the person to have surgery This assessment should include whatever tests are indicated but not include screening for conditions without an indication Immediately before surgery the person s body is prepared perhaps by washing with an antiseptic and if needed their anxiety is addressed to make them comfortable Contents 1 Technique 1 1 Addressing anxiety 1 2 Surgical site preparation 2 Risks 3 Special populations 3 1 Children 3 2 Recreational substance users 4 See also 5 References 6 External linksTechnique editAt some point before surgery a health care provider conducts a preoperative assessment to verify that a person is fit and ready for the surgery 1 2 For surgeries in which a person receives either general or local anesthesia this assessment may be done either by a doctor or a nurse trained to do the assessment 2 The available research does not give insight about any differences in outcomes depending on whether a doctor or nurse conducts this assessment 2 Addressing anxiety edit Playing calming music to patients immediately before surgery has a beneficial effect in addressing anxiety about the surgery 3 Surgical site preparation edit Hair removal at the location where the surgical incision is made is often done before the surgery 4 Sufficient evidence does not exist to say that removing hair is a useful way to prevent infections 4 When it is done immediately before surgery the use of hair clippers might be preferable to shaving 4 Bathing with an antiseptic like chlorhexidine does not seem to affect incidence of complications after surgery 5 However washing the surgical site with chlorhexidine after surgery does seem helpful for preventing surgical site infection 6 Risks editScreening is a test to see whether a person has a disease and screenings are often done before surgery Screenings should happen when they are indicated and not otherwise as a matter of routine Screenings which are done without indication carry the risks of having unnecessary health care Commonly overused screenings include the following Electrocardiograms ECGs are sometimes given before any kind of surgery as a matter of routine but are unnecessary if a person does not have new and worrisome symptoms and if the surgery is minor Eye surgery for example would not usually require an ECG 7 Cardiac imaging and cardiac stress tests are usually unnecessary for people who do not have a serious heart condition and who are having surgery unrelated to the heart 8 People in the United States using government healthcare services are especially likely to have this procedure without indication 9 Chest x rays are usually unnecessary for people under age 70 who are not having chest surgery and who do not have worrisome symptoms 10 Breathing tests are usually unnecessary for people who do not smoke do not have respiratory disease and who do not have symptoms 11 Carotid ultrasonography is usually unnecessary for people who have not had a stroke or mini stroke 11 Special populations editChildren edit Among children who are at normal risk of pulmonary aspiration or vomiting during anaesthesia there is no evidence showing that denying them oral liquids before surgery improves outcomes but there is evidence showing that giving liquids prevents anxiety 12 Recreational substance users edit Sometimes before a surgery a health care provider will recommend some health intervention to modify some risky behavior which is associated with complications from surgery Smoking cessation before surgery is likely to reduce the risk of complications from surgery 13 In circumstances in which a person s doctor advises them to avoid drinking alcohol before and after the surgery but in which the person seems likely to drink anyway intense interventions which direct a person to quit using alcohol have been proven to be helpful in reducing complications from surgery 14 See also editPrehabilitationReferences edit Ravindra P Fitzgerald J 2012 Surgical preoperative assessment Student BMJ 344 d7816 doi 10 1136 sbmj d7816 S2CID 164318333 a b c Nicholson Amanda Coldwell Chris H Lewis Sharon R Smith Andrew F Lewis Sharon R 2013 Nurse led versus doctor led preoperative assessment for elective surgical patients requiring regional or general anaesthesia Reviews 11 CD010160 doi 10 1002 14651858 CD010160 pub2 PMC 10981790 PMID 24218062 Bradt Joke Dileo Cheryl Shim Minjung Bradt Joke 2013 Music interventions for preoperative anxiety Reviews 2013 6 CD006908 doi 10 1002 14651858 CD006908 pub2 PMC 9758540 PMID 23740695 a b c Tanner Judith Norrie Peter Melen Kate Tanner Judith 2011 Preoperative hair removal to reduce surgical site infection Reviews 11 CD004122 doi 10 1002 14651858 CD004122 pub4 PMID 22071812 Webster Joan Osborne Sonya Webster Joan 2012 Webster Joan ed Preoperative bathing or showering with skin antiseptics to prevent surgical site infection PDF Protocols 9 CD004985 doi 10 1002 14651858 CD004985 pub4 hdl 10072 51996 PMID 22972080 Dumville Jo C McFarlane Emma Edwards Peggy Lipp Allyson Holmes Alexandra Dumville Jo C 2013 Dumville Jo C ed Preoperative skin antiseptics for preventing surgical wound infections after clean surgery Reviews 3 CD003949 doi 10 1002 14651858 CD003949 pub3 PMID 23543526 American Academy of Ophthalmology September 2013 Five Things Physicians and Patients Should Question Choosing Wisely an initiative of the ABIM Foundation American Academy of Ophthalmology retrieved 6 January 2013 American College of Cardiology September 2013 Five Things Physicians and Patients Should Question Choosing Wisely an initiative of the ABIM Foundation American College of Cardiology retrieved 10 February 2014 Sheffield Kristin M McAdams Patricia S Benarroch Gampel Jaime Goodwin James S Boyd Casey A Zhang Dong Riall Taylor S 2013 Overuse of Preoperative Cardiac Stress Testing in Medicare Patients Undergoing Elective Noncardiac Surgery Annals of Surgery 257 1 73 80 doi 10 1097 SLA 0b013e31826bc2f4 ISSN 0003 4932 PMC 3521863 PMID 22964739 American College of Radiology September 2013 Five Things Physicians and Patients Should Question Choosing Wisely an initiative of the ABIM Foundation American College of Cardiology retrieved 3 September 2014 a b Society of Thoracic Surgeons February 2013 Five Things Physicians and Patients Should Question Choosing Wisely an initiative of the ABIM Foundation Society of Thoracic Surgeons retrieved 18 December 2013 Brady Marian C Kinn Sue Ness Valerie O Rourke Keith Randhawa Navdeep Stuart Pauline Brady Marian C 2009 Preoperative fasting for preventing perioperative complications in children Reviews 4 CD005285 doi 10 1002 14651858 CD005285 pub2 PMID 19821343 Thomsen Thordis Villebro Nete Moller Ann Merete Thomsen Thordis 2014 Interventions for preoperative smoking cessation Reviews 2014 3 CD002294 doi 10 1002 14651858 CD002294 pub4 PMC 7138216 PMID 24671929 Oppedal Kristian Moller Ann Merete Pedersen Bolette Tonnesen Hanne Oppedal Kristian 2012 Preoperative alcohol cessation prior to elective surgery Reviews 7 CD008343 doi 10 1002 14651858 CD008343 pub2 PMID 22786514 External links editPreoperative care in the Surgery Encyclopedia Retrieved from https en wikipedia org w index php title Preoperative care amp oldid 1217845337, wikipedia, wiki, book, books, library,
