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Preoperative Evaluation/Patient Issues/Preparation for office based anesthesia

QUESTION:

In the brave new world of office-based anesthesia and surgery, what can be done on a cost-effective and convenient basis to make sure that patients, who usually arrive in the facility minutes before their procedure, are adequately prepared?

-- From Anonymous

REPLY:

Interesting that you ask this now because we recently devised an office based-anesthesia curriculum at Beth Israel Deaconess Medical Center - this is what we teach to our residents.

Here are a few excerpts that would best answer your question.

"A safe and comfortable experience for the patient must start before arriving on the day of a procedure. A nurse or anesthesiologist should have already interviewed the patient and given pre-operative directions concerning clothing, make-up, hair and beauty products, diet, herbal supplements, other medications, and the opportunity to answer patient questions."

"The psychological stress of surgery can be alleviated somewhat by a calm, confident, non-pharmacologic verbal communication. Part of the positive experience for the patient is an adequate preoperative evaluation, along with education about what to expect from the
anesthesia and surgery. A patient that is well informed is generally less anxious, requires less anesthesia and recovers more rapidly."

In practical terms, if a questionnaire is sent to the patient in advance this can be followed up the day prior or on that day by a nurse/anesthesiologist someone with a knowledge of the anesthesia issues who also has a kind, caring compassionate manner to allay patient fear and anxiety.

By doing so, the patient has a person with whom they are 'bonded' . The goal is to provide a safe, pleasant and comfortable experience. I hope this answers your concerns.

-- From Fred Shapiro, M.D., Boston, MA

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