Preoperative care refers to

health care Health care, or healthcare, is the improvement or maintenance of health via the preventive healthcare, prevention, diagnosis, therapy, treatment, wikt:amelioration, amelioration or cure of disease, illness, injury, and other disability, physic ...

provided before a

surgical operation Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery ...

. Preoperative care aims to do whatever is right to increase the success of the surgery. At some point before the operation, the healthcare 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 for conditions without an indication. Immediately before surgery the person's body is prepared, perhaps by washing with an

antiseptic An antiseptic ( and ) is an antimicrobial substance or compound that is applied to living tissue to reduce the possibility of sepsis, infection, or putrefaction. Antiseptics are generally distinguished from ''antibiotics'' by the latter's abil ...

, and if needed, 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 Anxiety is an emotion characterised by an unpleasant state of inner wikt:turmoil, turmoil and includes feelings of dread over Anticipation, anticipated events. Anxiety is different from fear in that fear is defined as the emotional response ...

about the surgery.

Surgical site preparation

Hair removal Hair removal is the deliberate removal of body hair or head hair. This process is also known as epilation or depilation. Hair is a common feature of the human body, exhibiting considerable variation in thickness and length across different po ...

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 tools, tool used to cut human hair. Hair clippers work on the same principle as scissors, but are distin ...

might be preferable to

shaving Shaving is the removal of hair, by using a razor or any other kind of bladed implement, to slice it down—to the level of the skin or otherwise. Shaving is most commonly practiced by men to remove their facial hair and by women to remove the ...

Bathing Bathing is the immersion of the body, wholly or partially, usually in water, but often in another medium such as hot air. It is most commonly practised as part of personal cleansing, and less frequently for relaxation or as a leisure activity. ...

with an antiseptic like

chlorhexidine Chlorhexidine is a disinfectant and antiseptic which is used for skin disinfection before surgery and to disinfect surgical instruments. It is also used for cleaning wounds, preventing dental plaque, treating yeast infections of the mouth, and ...

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.

Risks

Screening is a test to see whether a person has a

disease A disease is a particular abnormal condition that adversely affects the structure or function (biology), function of all or part of an organism and is not immediately due to any external injury. Diseases are often known to be medical condi ...

, 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 Unnecessary health care (overutilization, overuse, or overtreatment) is health care provided with a higher volume or cost than is appropriate. In the United States, where health care costs are the highest as a percentage of GDP, overuse was the ...

. Commonly overused screenings include the following: *

Electrocardiograms Electrocardiography is the process of producing an electrocardiogram (ECG or EKG), a recording of the heart's electrical activity through repeated cardiac cycles. It is an electrogram of the heart which is a graph of voltage versus time of ...

(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 Cardiac imaging refers to minimally invasive imaging of the heart using ultrasound, magnetic resonance imaging (MRI), computed tomography (CT), or nuclear medicine (NM) imaging with Positron emission tomography, PET or SPECT. These cardiac techniq ...

and

cardiac stress test A cardiac stress test is a cardiological examination that evaluates the cardiovascular system's response to external stress within a controlled clinical setting. This stress response can be induced through physical exercise (usually a treadmill) o ...

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 Smoke is an aerosol (a suspension of airborne particulates and gases) emitted when a material undergoes combustion or pyrolysis, together with the quantity of air that is entrained or otherwise mixed into the mass. It is commonly an unwante ...

, do not have

respiratory disease Respiratory diseases, or lung diseases, are pathological conditions affecting the organs and tissues that make gas exchange difficult in air-breathing animals. They include conditions of the respiratory tract including the trachea, bronchi, ...

, and who do not have symptoms. * Carotid ultrasonography is usually unnecessary for people who have not had a

stroke Stroke is a medical condition in which poor cerebral circulation, blood flow to a part of the brain causes cell death. There are two main types of stroke: brain ischemia, ischemic, due to lack of blood flow, and intracranial hemorrhage, hemor ...

or mini-stroke. *Laboratory tests, including

urinalysis Urinalysis, a portmanteau of the words ''urine'' and ''analysis'', is a Test panel, panel of medical tests that includes physical (macroscopic) examination of the urine, chemical evaluation using urine test strips, and #Microscopic examination, m ...

, white blood count, and a

pregnancy test A pregnancy test is used to determine whether a person is Pregnancy, pregnant or not. The two primary methods are testing for the pregnancy hormone (human chorionic gonadotropin (hCG)) in blood or urine using a pregnancy test kit, and scanning ...

Clearance

Surgical clearance, or preoperative medical clearance, is an evaluation to determine if a patient is healthy enough to undergo a planned surgery. The primary objective of this evaluation is to identify any existing medical conditions or risk factors that may lead to complications during or after the surgery. This allows healthcare providers to take necessary precautions and optimize the patient's health before the operation. The purpose is to lower modifiable risk during and after the surgery along with estimating total risk of undertaking the procedure.

Special populations

Children

Among children who are at normal risk of

pulmonary aspiration Pulmonary aspiration is the entry of solid or liquid material such as pharyngeal secretions, food, drink, or stomach contents from the oropharynx or gastrointestinal tract, into the trachea and lungs. When pulmonary aspiration occurs during ea ...

vomiting Vomiting (also known as emesis, puking and throwing up) is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose. Vomiting can be the result of ailments like food poisoning, gastroenteritis, pre ...

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 A public health intervention is any effort, policy, or program intended to improve mental and physical health at the population level. Interventions involve social movements that strive to support public health at different levels of society. Pub ...

to modify some risky behavior which is associated with complications from surgery.

Smoking cessation Smoking cessation, usually called quitting smoking or stopping smoking, is the process of discontinuing tobacco smoking. Tobacco smoke contains nicotine, which is Addiction, addictive and can cause Substance dependence, dependence. As a resu ...

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