Anesthetists and surgeons in ensuring preoperative optimization

Objective: This survey study was designed with the aim of questioning tobacco and alcohol use as two major components of preoperative optimization, evaluating the elements of the preoperative period other than the treatment of anemia, evaluating whether these elements were performed in compliance with the protocols by anesthetists and surgeons, and suggesting solutions for overcoming deficiencies.

Method: Specialist physicians in anesthesia and surgeons from several branches, who worked in 4 different healthcare centers in Istanbul, were included in this 15-question survey.

Results: A total of 116 physicians participated in this survey study. Of the participating physicians, 47 (40.5%) were anesthetists and 69 (59.5%) were surgeons.  A total of 115 (99.1%) physicians answered “yes” to the following question: “Do you inform and train your patient in the preoperative period about the scheduled surgical procedure/anesthesia method and the essential principles?”. To the question “do you stress to your patients in the preoperative period that stopping smoking is necessary for the period of 4 weeks prior to surgery?”, 88 (75.9%) physicians answered “yes”. Only 47 (40.5%) physicians answered “yes” to the following question: “In the preoperative period, do you stress to your patients using alcohol that stopping alcohol use is necessary for the period of 4 weeks prior to surgery?” 

Conclusions: Our survey study conducted with the participation of physicians with an experience of more than 10 years demonstrated favorable outcomes, revealing that all physicians provided information and training for their patients in the preoperative period and all but 1 physician followed up the blood sugar level of diabetic patients for regulating the blood sugar levels. However; we are of the opinion that further collaboration of physicians within a team concept and in compliance with the preoperative optimization guidelines will be useful to ensure early and fast recovery in the postoperative period by limiting the tobacco/alcohol use of patients in the preoperative period, providing appropriate nutrition preoperatively, enabling access of patients to prehabilitation, administering adequate premedication, and providing anemia management.