Pre-anesthetic checks

Pre-anesthetic evaluation is an overall assessment of the patient in order that their preoperative course is the best possible, should include history taking, physical examination and complementary examinations. no evidence which by definition must be compulsorily made, they must be requested the opinion of the anesthesiologist. The overall objective (11) of the pre-anesthetic assessment is to reduce perioperative morbidity and mortality, specific objectives are to improve the patient’s preoperative condition, improve their anxiety and anesthesia plan. The preanesthetic evaluation can be done on an outpatient or inpatient. The outpatient preanesthetic evaluation is one that particularly interests us in general anesthesia and sedation for dental procedures, it is usually performed in the faculty of dentistry at the Central University of Venezuela. In the case of outpatient evaluation, the patient is referred to the anesthesiologist or preanesthetic when doing surgical indication, the anesthesiologist after evaluation of the patient, requesting additional examinations that are required as well as evaluations by other specialists as needed. Following this, fix the date of the intervention. In the pre-anesthetic consultation should make a report of the findings and suggestions of the anesthesiologist results that assessment takes place, intended to provide anesthesia anesthesiologist, it may not be the same. In the case of anesthesia for dental procedures (12), the patient should receive the anesthesiologist, clear and detailed information about what you should do before surgery. Also take advantage of the pre-anesthetic consultation to inform parents because parents are an important part in the practice of procedures under sedation or general anesthesia (13), as to avoid possible complications, they must properly follow all pre and post operative instructions. The anesthesiologist should explain anesthetic techniques, monitoring and post-operative care that the child should receive. The pre-anesthetic consultation serves to provide all this information to the patient’s parents, as well as providing support to ease parents’ anxieties possible before the anesthetic procedure. Sedation in turn, also requires an assessment Preview as sedation guidelines (7), prepared by the committees of Anesthesiology and Pediatrics Societies of North America, it requires an assessment of the health status of the patient, such evaluation must be as rigorous as preanesthetic classical. Another purpose of preanesthetic evaluation is to place each patient into one of the groups of the classification “ASA”, which, according to the American Society of Anesthesiology, is a risk scale based on the patient’s general condition, in this way the degrees of classification “ASA” are:

  • ASA I: healthy patient.
  • ASA II: A patient with mild systemic disease or compensated.
  • ASA III: Patient with severe or decompensated disease.
  • ASA IV: Patient with life-threatening systemic.
  • ASA V: moribund patient.

According to the guidelines of sedation, the patient placed in the ASA III or IV categories, require special care and are not candidates to be sedated for dental procedures. Similarly, should not receive general anesthesia for ambulatory type require special postoperative care can only be provided in a hospital.

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