The European Society of Anaesthesiology (ESA) has published updated guidelines on the pre-operative evaluation of adults undergoing elective noncardiac surgery. In developing the guidelines, researchers screened more than 34,000 abstracts and analysed 2,536 further.
The document makes recommendations that address two main clinical questions namely; how should a pre-operative consultation clinic be organised and how should pre-operative assessment of a patient be performed. Among the updated recommendations is that pre-operative computer-based evaluation tools are used in patient assessments whenever possible. The authors also suggest a sufficient time lapse between pre-operative evaluation and the scheduled procedure to allow for the implementation of any advisable pre-operative intervention aimed at improving patient outcomes.
The guidance also includes a number of recommendations on specific conditions such as diabetes, cardiovascular disease and obesity including laboratory tests to detect pathological glucose/HbA1c concentrations and anaemia in the obese. It also provides recommendations on dealing with certain concurrent medications, pre-operative airway evaluation, and postoperative nausea and vomiting, among other areas.
Writing in the European Journal of Anaesthesiology, the authors said the guidelines should be regarded as an add-on and not necessarily a replacement of the 2011 ESA recommendations.