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[Objectives of consultation in anesthesia]
D Montpellier1, E Hayek, M Ossart
1Département d'Anesthésie-Réanimation, C.H.R.U., Amiens.
Abstract:
Recently developed in France (1970), pre-anaesthetic consultation continues to gain in importance because of a number of considerations. Psychological considerations: Consultation provides information about the patient to be operated, wins the patient's co-operation for his/her preparation for operation, and takes some of the drama out of surgery and anaesthetic. Medical considerations: More complete pre-operative examination (discovery of hereditary defects, and current medication) carried out by means of a long and very methodical interrogation, difficult to do at the patient's bedside. The best and most accurate possible assessment of the anaesthetic risk will reduce per- and post-operative complications or at least reduce their effects by better prevention and preparation of the patient, notably in the case of patients with respiratory problems, following possible complementary examinations or other specialized consultations. Anaesthetic considerations: By means of the choice and discussion of an anaesthetic technique according to the patient's own wishes, the anaesthetic risk, the type of hospitalization, especially in ambulatory anaesthetic, when pre-anaesthetic consultation is indispensable. Care coordination: The anaesthetist doctor assumes a double role of clinician and coordinator with the surgical team, the other specialists, and especially the general practitioner whose work he will continue when the patient is hospitalized, and who will have a leading role in the pre-operative preparation of the patient, and the realization of complementary examinations often carried out at home. The consultation makes for a per-operative approach which is carried out earlier, is more complete and more humane.