Abstract
Pre-operative assessment is required prior to the majority of elective surgical procedures, primarily to ensure that the patient is fit to undergo surgery, whilst identifying issues that may need to be dealt with by the surgical or anaesthetic teams. The post-operative management of elective surgical patients begins during the peri-operative period and involves several health professionals. Appropriate monitoring and repeated clinical assessments are required in order for the signs of surgical complications to be recognised swiftly and adequately.This article examines the literature regarding pre-operative assessment in elective orthopaedic surgery and shoulder surgery, whilst also reviewing the essentials of peri- and post-operative care. The need to recognise common post-operative complications early and promptly is also evaluated, along with discussing thromboprophylaxis and post-operative analgesia following shoulder surgery.
Highlights
Pre-operative assessment is necessary prior to the majority of elective surgical procedures, in order to ensure that the patient is fit to undergo surgery, to highlight issues that the surgical or anaesthetic team need to be aware of during the peri-operative period, and to ensure patients’ safety during their journey of care
The National Institute for Clinical Excellence (NICE) does not recommend routine preoperative chest X-rays for otherwise healthy patients unless cardiac surgery is to be performed, but states that the decision depends upon the clinical history (e.g. chronic obstructive pulmonary disease (COPD), asthma) and the pathology requiring surgery [8, 14]
It draws attention to the mainstays of this assessment, which are a detailed history and clinical examination must be conducted, and additional tests and investigations be requested which are specific to the needs of the individual
Summary
Pre-operative assessment is necessary prior to the majority of elective surgical procedures, in order to ensure that the patient is fit to undergo surgery, to highlight issues that the surgical or anaesthetic team need to be aware of during the peri-operative period, and to ensure patients’ safety during their journey of care. This article examines the literature regarding preoperative assessment in elective orthopaedic surgery and shoulder surgery, whilst reviewing the essentials of periand post-operative care. Most patients admitted for elective surgery undergo a range of routine pre-operative tests.
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