What is perioperative medicine?
Perioperative medicine is the field of medicine that deals with the optimisation of long-standing
medical conditions (such as diabetes, heart failure, COPD/emphysema etc.) before and after surgery.
Many long-standing medical conditions can increase the risk of complications during or after
surgery. The aim of a perioperative review is to ensure that your long-standing medical conditions
are well optimised prior to surgery.
What is involved in a perioperative assessment?
A comprehensive medical assessment will be undertaken to go through your medical history,
medications, allergies and your ability to perform daily activities and exercise. A thorough
examination will be performed to assess your physical health. If required, blood tests and other
investigations (such as a chest X-ray, echocardiogram and lung function tests) will be ordered.
Following this, a detailed plan to optimise your medical condition(s) and a comprehensive
medication management plan will be offered prior to surgery.
How long will the optimisation process take?
It depends on your individual circumstances and how well controlled your current medical
conditions are. Multiple medical conditions can increase your risk of complications during or after
surgery. Complications can include death during surgery, poor wound healing, poorly-controlled
blood sugars during the surgical period and recovery, and side effects from certain medications that
should ideally be withheld prior to surgery. As you can imagine, “fixing” a long-standing condition is
often next to impossible. The aim of these assessments is to fine-tune your medical conditions as
much as possible so that the we reduce (but NOT eliminate) the risk of surgical complications as
much as possible.
Will I be cleared for surgery?
The intent for a perioperative assessment is not to ‘clear’ you for surgery. The term ‘cleared for
surgery’ implies that all risks pertaining to your surgery have been eliminated. This, as you can
appreciate, is impossible. All surgeries carry risks and the aim is to fine-tune your long-standing
medical conditions to facilitate a safer surgery and post-surgical experience. You will still need to
discuss your individual circumstances with your surgeon and your anaesthetist to get a
comprehensive picture of the benefits and risks.
Will I need to see you after my surgery?
In most instances, yes. It would be helpful to review you after your surgery to see if any further
changes are required, such as restarting certain medications, organising further follow-up, etc.
Who else is involved in this process?
As with most things in medicine, we operate as a multidisciplinary team. Anaesthetists, surgeons and
other specialists (for example, lung or heart specialists) may be involved in your care.
