Preoperatif

Preoperatif, or the preoperative period, is the phase before a surgical procedure in which a patient is evaluated and optimized to reduce perioperative risk and improve outcomes. The goals are to identify conditions that could complicate anesthesia or surgery, ensure appropriate testing, and prepare the patient physically and psychologically.

Key activities include medical history and physical examination, risk assessment (often using ASA status), and targeted testing such as blood work, ECG, imaging, or pulmonary evaluation as indicated. Anesthesia evaluation and airway planning are part of preoperative assessment, and medications may need adjustment—holding anticoagulants or antiplatelets, adjusting insulin, and giving perioperative instructions for other drugs. Patients receive guidance on fasting (NPO) and perioperative fluid management.

Optimization efforts address modifiable risks, including treatment of anemia, improvement of nutrition, smoking cessation, and control of chronic diseases like hypertension and diabetes. Special considerations apply for obesity, sleep apnea, kidney disease, or other comorbidities. Vaccinations or prophylactic measures may be advised when relevant.

Informed consent and patient education are central, covering the planned procedure, anesthesia approach, possible complications, recovery expectations, and postoperative plans. Preventive strategies commonly include timing of antibiotic prophylaxis, thromboembolism prevention, and infection control.

The preoperative phase is typically conducted in a preoperative clinic or through a preadmission testing program and is integrated with the surgical safety checklist to confirm readiness for anesthesia and surgery. Effective preoperative preparation supports safer anesthesia, smoother surgery, and better recovery.