Anesthesiologist Consultation

The anesthesiology consultation is a medical evaluation performed by a specialist in anesthesiology and intensive care prior to a surgical intervention or a procedure requiring anesthesia. The purpose of this consultation is to assess the patient’s general health status, anesthetic risks, and to safely plan the type of anesthesia to be used.

Purpose

• Assessment of the patient’s general clinical condition and risks associated with anesthesia.
• Selection of the optimal anesthesia method (general, regional, or local).
• Preparation of the patient for the anesthetic procedure.

Main Objectives

• Collection of medical history and evaluation of functional status (cardiovascular, respiratory, renal, etc.).
• Classification of anesthetic risk according to the ASA (American Society of Anesthesiologists).
• Establishment of the type of anesthesia and intraoperative monitoring plan.
• Identification of contraindications, allergies, and drug interactions.
• Patient education regarding preoperative preparation.

Stages of the Consultation

• Detailed medical history: chronic diseases, previous surgeries, allergies, current treatments.
• Clinical evaluation: hemodynamic, respiratory, neurological status, etc.
• ASA classification and assessment of individual risks.
• Selection of the appropriate anesthetic technique (depending on the surgical procedure).
• Information regarding preoperative and postoperative preparation, including dietary and medication restrictions.

Indications

• Scheduling of a surgical intervention under general, regional, or local anesthesia.
• Need for pre-anesthetic evaluation in patients with multiple comorbidities.
• Preoperative risk assessment for invasive procedures.
• Evaluation of patients requiring deep sedation or anesthesia for diagnostic procedures (e.g., colonoscopy, MRI).

Procedure

• Initial discussion and collection of medical history.
• General clinical examination.
• Evaluation of anesthetic risk and ASA classification.
• Explanation of anesthesia options and associated risks.
• Development of a personalized anesthetic plan.
• Patient instructions regarding preoperative and post-anesthetic behavior.

Duration and Scheduling of Visits

• Consultation duration: approximately 20–40 minutes.
• Validity period: the consultation must be updated within 48 hours prior to surgery. It may be performed 14–30 days before the intervention, but validity must be confirmed within the last 48 hours before surgery.
• Possible re-evaluation: if changes occur in the patient’s health status or if the planned intervention is modified.

Sources:

https://pmc.ncbi.nlm.nih.gov/articles/PMC2464262/
https://pubmed.ncbi.nlm.nih.gov/39492705/
https://anesthguide.com/topic/preoperative-assessment/
https://www.asahq.org/quality-and-practice-management/managing-your-practice/timely-topics-in-payment-and-practice-management/distinguishing-between-a-pre-anesthesia-evaluation-and-a-separately-reportable-evaluation-and-management-service