Pre-Operative Anaesthetic Assessment

The assessment of your capacity to tolerate anaesthetia is an important part of the decision to have surgery. You may see an anaesthetist during the pre-operative period, but in most cases your surgeon will perform an assessment then refer you on if required. If your surgeon thinks you are at increased risk, you may need to 'optimise' your other medical conditions before surgery can be performed.

Who has higher risk for complications during anaesthetic?

Sufferers of heart or lung disease have an increased risk of complications with anaesthetic. Other risk factors include:

  • Advanced age
  • Diabetes
  • Obesity

If you are at higher risk, your doctor will take extra precautions to make the surgery as safe as possible.

Components of the Anaesthetic Assessment

Examining your heart and lungs:

  • Chest X-Ray
  • ECG - a simple test using probes on the skin to monitor the electrical activity in your heart.
  • Stress Test - a stress test is performed to see how your body copes with increased demands. Usually this will involve riding on a stationery bicycle while your breathing, heart and lungs are monitored. This will give the doctors a good assessment of
  • Less commonly performed tests include:
    • Lung Function Tests
    • Echocardiogram - an ultrasound scan of the heart to check the power of the muscle and how well the valves are working
    • Angiograms - tests that look at the size and health of blood vessels

Other tests and examinations:

  • Blood tests - a series of routine tests are usually performed per-operatively to check the blood and kidneys.
  • Mouth and throat assessment - to assess how easily a tube can be inserted into the throat to deliver oxygen if needed
  • X-Rays of the neck (usually only necessary in some rheumatoid arthritis patients)

What happens after the assessment? Can I still have surgery?

In most cases, your anaesthetist and surgeon will still be able to perform necessary surgery even if you are considered at 'high risk' - but to do so they will need to put in place extra precautions.

In some cases, your surgeon may recommend other forms of treatment, like plaster casts or walking aids to delay surgery until you're ready.

As a general rule, surgeries that do not require general anaesthesia but can be performed with only local or regional blocks, or spinal anaesthesia can still be performed.

What should I tell my doctor?

Please make sure your surgeon or anaesthetist knows if you have:

  • A history of snoring, or are aware of waking with headaches, feeling tired or falling asleep during the daytime
  • Family history of reaction to anaesthetic
  • Previous reactions to antibiotics
  • Severe motion sickness
4 August, 2012