本院における麻酔科術前診療依頼の現状と問題点

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  • Evaluation of the Preanesthetic Consultation Clinic in Keio University Hospital.

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Surgical procedures can be delayed and canceled because of inadequate preoperative assessment and preparation. In order to prevent such inappropriate patient care, we evaluated whether our preanesthetic clinic worked properly. We describe here the pattern of case referrals and the efficiency of our consultation clinic. Data were collected retrospectively of 432 patients at Keio University Hospital from September 1996 to February 1997. The majority of referrals were regarding patients undergoing otolaryngological, orthopedic, general surgical, or obstetric and gynecological procedures, and the distribution for these four departments was 67.4%. The primary reason for referral was related to the cardiovascular involvement in 34%, respiratory involvement in 19%, and endocrine involvement in 12% of referral cases. Eighty-eight percent of referrals were considered as appropriate, while the remaining 12% of consultations seemed inappropriate, including almost healthy patients, or the patients without enough data for appropriate preoperative evaluation. In order to make the preanesthetic consultation clinic more effective, we plan on a guideline for preoperative evaluation. We believe that this new system of the consultation clinic should be established for better perioperative management, including education of surgeons regarding preoperative patient care.

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