[Preanesthetic evaluation, preparation and prognostic prediction for chronic obstructive pulmonary disease (COPD)]

The most important matter in pre-anesthetic evaluation for patient with COPD is not recognition of clinical staging but of severity. Because the staging is classified only by spirometric examination, we should evaluate the severity of disease in individual patients from symptoms of cough, sputum production, dyspnea, history of exposure to risk factors (smoking), exercise tolerance, complication, or weight loss. It is necessary for patients to be abstaining from smoking, be vaccinated against respiratory infections and medicated with bronchodilators (beta2-agonists) before operation. Additionally, we need to recognize COPD as a systematic disease, and consider intensive care in postoperative period.