[The pre-anesthetic consultation]

The French law of December 4, 1994 has made the preanaesthetic consultation a mandatory part of the perioperative process. This consultation should be performed several days before surgery when the procedure is scheduled. This law has established that every patient undergoing surgery or an invasive procedure requiring anaesthesia should have a medical encounter with an anaesthetist to evaluate the risks associated with the procedure, inform the patient about the process and obtain his (her) agreement for the planned clinical pathway. During this encounter, the anaesthetist will also assess the perioperative risks related to an underlying disease (especially cardiac, respiratory and renal) while optimisation of a pre-existing condition is sometimes necessary before surgery. Patient's regular treatment might require some changes related to the effect of anaesthesia (antihypertensive drugs and risk of hypotension) or to the surgery (bleeding and anticoagulants/antiplatelet drugs). It is believed that the role of the general practitioner will increase significantly in the next years both in the preoperative period (drug adjustment, specific investigations) and in the postoperative period (especially after ambulatory surgery or in situations associated with a short hospital stay).