History

The patient is visited pre-operatively both to assess their fitness for anaesthesia, to decide the best means of anaesthesia, and to explain the course of the anaesthesia.

Important points in the history include:

• existing cardiorespiratory disease:
  • particularly the limitation of function, e.g. distance can walk
  • a standardized set of screening questions for undiagnosed conditions, e.g. chest pain, shortness of breath
• intercurrent medical conditions:
  • diabetes
  • rheumatic fever
  • epilepsy
  • jaundice
  • rheumatoid arthritis
• existing medication
• allergies
• past admissions to hospital, operations, dental procedures - caps, bridges or reactions to anaesthetic, any recent general anaesthetic or "awareness" while under general anaesthesia
• family history:
  • relative with poor anaesthetic history
  • cholinesterase problems
  • sickle cell disease or trait
  • porphyria
  • dystrophia myotonica
  • malignant hyperpyrexia
• social history:
  • smoking
  • alcohol intake
  • drug abuse
  • likelihood of pregnancy