What is a preoperative evaluation?
9/23/2024 by Karen Mauck, M.D., M.S.
A preoperative evaluation prior to surgery aims to identify specific factors about your health or the surgical procedure that may increase your risk for complications after surgery. For patients with many medical problems, this appointment can help the patient and the surgical team better understand the risks of the planned surgery. A careful preoperative evaluation can often identify opportunities to reduce specific risks with strategies unique to each patient's medical condition.
Preoperative evaluation visits are often performed by anesthesiologists, family medicine doctors, internal medicine doctors or advanced practice providers. Only some patients will need a preoperative evaluation; it depends on their medical conditions and the risk of the proposed surgical procedure. The evaluations are usually done a few weeks before surgery but often are done the day before the planned surgery.
During this evaluation, you will be asked direct questions regarding the following:
- Your health conditions, how they are currently being managed and how well controlled they are.
- A detailed list of all medications with dosages, including supplements that you take (this includes medications that are injected or infused intermittently).
- Medication allergies.
- Functional abilities (e.g., taking care of yourself, exercise ability, etc.).
- Nutritional status.
- Prior surgeries and anesthesia.
- Prior complications related to anesthesia or surgery.
- Prior heart, respiratory, bruising or bleeding problems.
- Prior history of blood clots.
- Information about any medical device placed in your body (e.g., pacemaker, defibrillator, pain pump, etc.) or a medical device used regularly (e.g., CPAP, insulin pump, continuous glucose meter).
- Current use of alcohol, tobacco, nicotine or other substances.
- Review any recent laboratory testing, x-rays, heart/lung tests or outside medical records.
Your clinician will perform a detailed history and examination, discuss important risks and recommend which medications to hold or adjust before surgery. During this visit, you will have the opportunity to ask questions to understand the risk of potential complications and how best to prevent them, if possible. If your preoperative visit is with an anesthesiologist, you can discuss if there are different options for anesthesia. However, suppose you have specific questions about the surgical procedure itself (e.g., details about the surgical procedure itself, how long recovery is expected to take, how many days in the hospital, the plan for pain medications, etc.). In that case, it is best to discuss these directly with the surgeon or the surgical team.
Karen F. Mauck, M.D., M.S., is a physician in the Division of General Internal Medicine, Mayo Clinic in Rochester. She is chair of the Preoperative Evaluation Clinic in General Internal Medicine.