Preoperative medical evaluation of the healthy patient

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Presentation of a Case

24 year old man is scheduled for elective herniorrhaphy surgery. As the primary physician you are called "to clear" the patient for surgery. The patient has no known medical illnesses. He has no family history suggestive of Diabetes and Hypertension.
He has no allergies and is not taking any medications. He has had no previous surgeries. Physical examination is otherwise normal.

Discussion

The objectives of preoperative evaluation are to determine the risk to the patient of the proposed procedure and to minimize known risks. These are achieved by the following:

  • Identifying unrecognized comorbid disease and risk factors for medical complications of surgery
  • Optimizing the preoperative medical condition
  • Recognizing and treating potential complications
  • Working effectively as a member of the preoperative team (including surgical and anesthesia colleagues)

In a healthy patient as the one described above with very low risk of mortality, a very minimal evaluation is sufficient prior to surgery. The factors influencing peri and postoperative risk and the evaluation in healthy patients are enumerated below.

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