Preoperative preparation of patients for surgery under anesthesia within family medicine

Abstract: Typical preoperative preparation includes a series of standard diagnostic tests (electrocardiogram, radiological examinations of the heart and lungs, laboratory tests, etc.), risk assessment and, if necessary, temporary replacement of therapy. Up to 70% of the standard performed preoperative tests do not contribute to reducing surgical complications and mortality, do not change the performance of the procedure, but can delay it and create unnecessary costs. Therefore, the guidelines for preoperative preparation recommend only those tests that check previously known diseases and risks. Furthermore, anticoagulant therapy does not need to be discontinued before procedures under local and minor general anesthesia, and heparin bridging is indicated for others. The use of all medications is safe for low-risk surgical procedures, while for other procedures, modification of a small number of frequently used medications is required. Despite the recommendations and guidelines of professional societies, large deviations are visible in everyday work, which can cause complications of the underlying disease, postponement of the surgical procedure and unnecessary costs to the healthcare system. An individual assessment of the need for individual examinations that considers all risks and comorbidities can speed up the preoperative procedure and reduce costs without jeopardizing the patient‘s safety and the quality of the health care provided.

Key words:
anticoagulant drugs; comorbidities; general anesthesia; perioperative procedures