The preoperative period encompasses the time between the patient's admission to the hospital and start of the operation.
The duration of the period may vary with a number of factors, such as
• type of disease;
• severity of the patient's condition;
• nature of the surgery.
The main purposes of the preoperative period are as follows:
1) to define the problem (i.e. to make the diagnosis);
2) to identify other conditions that may influence anaesthesia or surgery (i.e. to determine the indications and contra-indications, urgency and type of operation to be performed);
3) to prepare the patient for the operation (to minimise the risk associated with the surgery and that of postoperative complications):
• to evaluate the functions of all body systems (including the operative site) and thus to prevent their deterioration;
• to identify and, whenever necessary, eradicate endogenous infection;
• to prepare the patient psychologically;
• to choose and provide the patient with appropriate anaesthesia.
Depending on the urgency operations are classified as:
1. Emergency operations should be performed either immediately or within several hours after the patient's admission to the surgical unit.
2. Urgent operations are to be undertaken within a few days after admission.
3. Elective operations are those that have been previously scheduled.
DETERMINING
THE URGENCY OF SURGERY
The time within which an operation has to be performed varies with indications that fall into the three categories: life-saving, absolute and relative.
Life-saving indications imply that the least delay in performing the operation would result in the patient's death. The following may serve as examples: