Die präoperative Einschätzung und perioperative Betreuung von Patienten können, je nach individuellem Risiko, eine erhebliche Herausforderung darstellen. Mit der neuen Guideline der European Society of Anaesthesiology wollen die Autoren zur Entscheidungsfindung eines optimalen Managements vor elektiven Eingriffen beitragen.
Preoperative evaluation of patients – new ESA Guidelines
In June 2018, a revised version of the 2011 ESA Guidelines on Preoperative Evaluation of Patients undergoing Non-cardiac Surgery was published. Major changes were made by an international group of experts based on recent literature and data. Their main goal within these guidelines is to answer two basic questions: How should preoperative evaluation be organized? How should the patient be evaluated, including a profound risk assessment? Due to contradictory or insignificant data or studies of low quality one will mainly find recommendations with rather low grades of evidence. As mentioned by the authors themselves, the guidelines will provide a framework for the anesthetist to work with rather than offering a specific strategy. In the recent past, international guidelines on single aspects of preoperative evaluation have been published, especially in Europe there are guidelines on specific groups of patients, like patients with diabetes or the geriatric patient. The 2018 ESA Guidelines therefore often refer to those guidelines as cross-references. Specific topics, like for example pregnancy, are not part of the guidelines at hand. Also, a section about how to handle allergies has been taken out compared to the previous version.
Schlüsselwörter
präoperatives Risiko - Anästhesiologie - Chirurgie - Leitlinie
Keywords
preoperative risk - anesthesiology - surgery - guideline
