The Preoperative Assessment Clinic (PAC) is an innovative, efficient, and newly remodeled, patient-friendly clinic. The PAC provides preoperative preparation and evaluation for over 16,000 outpatients and same-day surgery patients each year. The Anesthesiology Department has an attending anesthesiologist, two physician assistants, and a nurse clinician dedicated full-time to the clinic. In addition, an intern and a resident physician in the Anesthesiology Department also learn preoperative assessment and diagnostic testing on a daily basis. While we routinely obtain our own testing, including noninvasive cardiac and pulmonary tests, a variety of consultants are available for more complex patients. Six nurses also work daily in the PAC obtaining medical information that might be needed and providing instruction for the patient’s perioperative period. An electronic Preoperative Assessment system has become an integral part of patient evaluations and is linked to an intraoperative anesthesia electronic record for continuity of patient information and care.
In the Preoperative Assessment Clinic you will answer a questionnaire that reviews your medical and surgical history and problems. You will need to bring the medications you take in the original pharmacy bottles and be prepared to tell us what medicines you are allergic to. We will discuss with you how to take your medications before surgery. IF YOU HAVE HEART STENTS, A PACEMAKER, OR ICD, PLEASE BRING YOUR WALLET CARD. Then you will be interviewed by one of the nurses who will verify this information. This will be followed by the anesthesia evaluation. A brief physical examination will occur, such as listening to your heart and lungs. A brief description of the types of anesthesia that might be used for your surgery will be reviewed. If your surgery is fairly simple and superficial, you might only have sedation and the surgeon will use local anesthetics. For more complex surgeries you might receive a general anesthetic (where you are “asleep”) or a regional anesthetic (where just your arm or leg or lower body is “numbed”). The anesthetic will also be discussed with you on the day of surgery, and the final decision about the anesthetic is made then.
After the anesthesia evaluation and discussion the nurse will discuss preoperative instructions with you. You will also be given a map that will help direct you on your day of surgery. You will usually not be told the time of surgery until the day before surgery.
Blood testing, electrocardiograms (heart tracings), chest X-rays and other tests may be done after your anesthesia evaluation. These tests are ordered based on health problems you may have, medications you take, and the nature of the surgery. Often, these tests have already been ordered and/or completed by your surgeon or medical doctor. Tell your surgeon if you take Plavix, Coumadin, or other blood thinners. Seldom do these drugs affect the anesthetic, but your surgeon may want you to stop taking these drugs because of potential bleeding problems. Your surgeon may need to talk with your medical doctor about when to stop and restart these drugs.
If you have a pacemaker or ICD, you will be referred to our cardiology device clinic so that the appropriate evaluation may occur.
Additional Resources
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As a patient you might have questions about other anesthesia-related parts of your upcoming surgery. Many answers may be found in the following link: http://www.asahq.org/patientEducation/anesandyou.htm |
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Please contact the Preoperative Assessment Center (336-716-3245) for any questions you have that are not answered in this material. |
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Smoking and Tobacco Cessation (pdf brochure-115kb) |
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Maps to Preoperative Assessment Clinic and to Surgical Services for the day of surgery. |
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