No pre-op assessment?

[Z064life]

Hi Guys,
I'm having a minor op on generalanesthetic (circumcision). I've been told I don't need a pre-op assessment but I'm not particularly comfortable with this. Should I be worried? I understand that a pre-op assessment is not a legal requirement and there is usually the opportunity to discuss the surgery etc on the day, before the anesthetic is applied.


Thanks

[jkh112]

I wouldn’t worry. I have had a few operations over the past few years ( none involving my old man though!). For some of these I had a pre-op and for some I did not and I spoke to the surgeon and the anaesthetist before I was taken to the operating theatre.
The only time I found the pre-op really useful was when I was having one of the more complicated procedures and there were options on how the surgeon could tackle it.
You will be fine, you are just getting one less visit to hospital which is a good thing considering how many sick people are there.

[carinatauk]

I have found that I have only had pre-op when there involves an internal exam or general anesthesia.

Sometimes I don't want to know the details. I went in for a operation on my leg due to a motorcycle accident, it was to repair a internal deglove with a large hematoma [morel-lavelle for medical boffs]. The surgeon told me all about it in the hour before the op, I was all for jumping off the trolley on the way to theatre. Sometimes it becomes too much information.

As it was, the operation ended up being totally different and more complicated, and a longer stay with in theatre and hospital. So in the end I was pleased I had it done.

That said I have only had one op on the manly piece, and that was just the 'snip'

[The_Doc]

Z064life said:

Hi Guys,
I'm having a minor op on generalanesthetic (circumcision). I've been told I don't need a pre-op assessment but I'm not particularly comfortable with this. Should I be worried? I understand that a pre-op assessment is not a legal requirement and there is usually the opportunity to discuss the surgery etc on the day, before the anesthetic is applied.
Thanks

Pre-op assessment is usually to prepare for anaesthesia and same day admission. So this is General Anaesthesia (GA) or Neuroaxial (spinal). We used to admit people the night before and do bloods and ECG, but it's a waste of valuable bed resource.
Also pre-op screening is needed for MRSA swabs, which take a few days to process and are quite often used in elective surgery. Under the age of 50 and for a short GA, with little previous medical history, it is rare for any bloods or ECG to be needed.

None of this even touches on questioning the surgeon before consent or agreement to surgery. This is a totally different kettle of fish and quite rightly, as you say, needs to be covered fully before anaesthesia. You need enough time to retain and weigh up the info you have been given before coming to a YES decision. This is Informed Consent.

If you are in two minds about the procedure or have questions which might change your agreement to the procedure , then the day of surgery is really very late for this. If you cancel on day (quite rightly if you want to) then the timeslot for your op in theatre is wasted and it is very very valuable. You might only have 10 mins with the surgeon before operation, on the day it's all systems go and a certain assumption is made (and rechecked) that by this point all questions have been answered...

Can you ring your surgeon's secretary and see him/her before in clinic to discuss the operation? This isn't pre-op assessment, this is clinical care.

FYI and slightly off topic, I read a paper looking at costings for operations in the USA, and costs for theatre time were about $3,000 to $5,000 for each 15 mins in the operating theatre......

[Riley Blue]

A few years ago I was diagnosed with prostate cancer and decided on surgery. I had a pre-op assessment during which it was discovered I had a heart irregularity. Further tests and scans followed resulting in surgery being ruled out as too risky. As a result, I now have three stents and am on medication.

Supposing I'd never had that pre-op assessment - it's likely my heart problem would never have been discovered as I have never, ever had any palpitations, twinges, aches or chest pains.

[The_Doc]

Yes, that's exactly what pre-op assessment is for.

As the length of an operation, it's complexity, or the patient age decreases, the need for pre-op assessment decreases too. There are no hard and fast rules.

I'm a surgeon and my wife is a Pre-assessment Sister