Preoperative care refers to

health care Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health profe ...

provided before a

surgical operation Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...

. The aim of preoperative care is to do whatever is right to increase the success of the surgery. At some point before the operation the health care provider will assess the fitness of the person to have surgery. This assessment should include whatever tests are

indicated In medicine, an indication is a valid reason to use a certain test, medication, procedure, or surgery. There can be multiple indications to use a procedure or medication. An indication can commonly be confused with the term diagnosis. A diagnosis ...

, but not include

screening Screening may refer to: * Screening cultures, a type a medical test that is done to find an infection * Screening (economics), a strategy of combating adverse selection (includes sorting resumes to select employees) * Screening (environmental), a ...

for conditions without an indication. Immediately before surgery the person's body is prepared, perhaps by washing with an antiseptic, and whenever possible their anxiety is addressed to make them comfortable.

Technique

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. 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. The available research does not give insight about any differences in outcomes depending on whether a doctor or nurse conducts this assessment.

Addressing anxiety

Playing calming music to patients immediately before surgery has a beneficial effect in addressing anxiety about the surgery.

Surgical site preparation

Hair removal at the location where the surgical incision is made is often done before the surgery. Sufficient evidence does not exist to say that removing hair is a useful way to prevent infections. When it is done immediately before surgery, the use of

hair clippers A hair clipper, often individually called the apparent plurale tantum hair clippers (in a similar way to ''scissors''), is a specialised tool used to cut human head hair. Hair clippers work on the same principle as scissors, but are distinct fr ...

might be preferable to shaving. Bathing with an antiseptic like chlorhexidine does not seem to affect incidence of complications after surgery. However, washing the surgical site with chlorhexidine after surgery does seem helpful for preventing

surgical site infection Perioperative mortality has been defined as any death, regardless of cause, occurring within 30 days after surgery in or out of the hospital. Globally, 4.2 million people are estimated to die within 30 days of surgery each year. An important consid ...

Risks

Screening Screening may refer to: * Screening cultures, a type a medical test that is done to find an infection * Screening (economics), a strategy of combating adverse selection (includes sorting resumes to select employees) * Screening (environmental), a ...

is a test to see whether a person has a disease, and screenings are often done before surgery. Screenings should happen when they are

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. * Cardiac imaging and

cardiac stress test A cardiac stress test (also referred to as a cardiac diagnostic test, cardiopulmonary exercise test, or abbreviated CPX test) is a cardiological test that measures the heart's ability to respond to external stress in a controlled clinical environ ...

s are usually unnecessary for people who do not have a serious heart condition and who are having surgery unrelated to the heart. People in the United States using government healthcare services are especially likely to have this procedure without indication. * Chest x-rays are usually unnecessary for people under age 70 who are not having chest surgery and who do not have worrisome symptoms. *Breathing tests are usually unnecessary for people who do not smoke, do not have respiratory disease, and who do not have symptoms. *

Carotid ultrasonography Carotid ultrasonography is an ultrasound-based diagnostic imaging technique to evaluate structural details of the carotid arteries. Carotid ultrasound is used to diagnose carotid artery stenosis (CAS) and can assess atherosclerotic plaque morpholo ...

is usually unnecessary for people who have not had a

stroke A stroke is a medical condition in which poor blood flow to the brain causes cell death. There are two main types of stroke: ischemic, due to lack of blood flow, and hemorrhagic, due to bleeding. Both cause parts of the brain to stop functionin ...

mini-stroke A transient ischemic attack (TIA), commonly known as a mini-stroke, is a minor stroke whose noticeable symptoms usually end in less than an hour. TIA causes the same symptoms associated with strokes, such as weakness or numbness on one side of ...

Special populations

Children

Among children who are at normal risk of

pulmonary aspiration Pulmonary aspiration is the entry of material such as pharyngeal secretions, food or drink, or stomach contents from the oropharynx or gastrointestinal tract, into the larynx (voice box) and lower respiratory tract, the portions of the respira ...

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.

Recreational substance users

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. 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.

References

{{reflist

External links

Preoperative care
in the ''Surgery Encyclopedia'' Surgery