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The pre-anesthetic evaluation for ophthalmic surgery in the elderly is really necessary? The reality of a public hospital

ABSTRACT

Objectives:

Pre-anesthetic assessment (PAA) and laboratory tests are questioned for ophthalmic procedures due to their additional costs and surgery delays. These are lower risks, nonetheless, patients are elderly and suffer from multiple comorbidities. The aim of this study was to determinate if it is really necessary in a public hospital.

Method:

a retrospective study on 297 medical records containing the pre-anesthetic questionary from ophthalmic surgery patients in a public hospital was leaded. By the anamnesis, clinical examination and laboratory tests, the rate of patients who came up with unknown or uncontrolled diseases for the pre-anesthetic evaluation among with unsettled lab tests were analyzed.

Results:

The patients's mean age was 71.5 years old. 95.28% of them suffer from at least one chronic disease. The most prevailer illness was systemic arterial hypertension (SAH) (62.96%), which in 7.7% of were uncontroled. Also 2.3% had no diagnosis of SAH. The DM2 appeared in second (22.22%), with 5.3% without proper management. Glycaemia above 100 mg.dl1 was found in 25.92%, undiagnosed; 84.8% of the total were taking at least one medication. Only 73.4% of patients were released for surgery in the first moment.

Discussion:

To sum up, PAA in ophthalmology surgery is able to bring up undiagnosed diseases, or unstable medical conditions, and it plays a role not only in optimize the patient for surgery, but also as primary care. It can be an important deal to improve population's health, therefore, considered necessary in elderly patients in the public health system.

Keywords:
Pre-anesthetic assessments; Anaesthesia; Ambulatory anaesthesia; Cataract extraction; Aged

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