In the first of a new series on anaesthesia Nina Ruth Lewis and Jo Fitz-Henry explain why preoperative investigations are so important to anaesthetists
During your time at medical school most of you will spend only a few days studying the glorious art that is anaesthesia. Preoperative investigations are the constant source of anguish in a house surgeon's life. Please take heart, we fully appreciate that you will never win. A thorough history and examination will give us most of the answers, but investigations, guided by our clinical skills, will help us to complete the picture. There is no place for “routine” preoperative investigations - they are unpleasant for the patient (venepuncture) or involve unnecessary risk (x ray examinations), but they are also a waste of money.
When the anaesthetic assessment is complete, the anaesthetist will grade the patient according to his or her physiological reserve and the attendant risk from both anaesthesia and surgery (the other thing that upsets the patient's physiology). The most common scoring system in use was devised by the