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2002, Número 4

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Rev Mex Anest 2002; 25 (4)


Consulta preanestésica.

Haberer JP

Idioma: Español
Referencias bibliográficas: 88
Paginas: 298-311
Archivo PDF: 229.05 Kb.


RESUMEN

Laconsultapreanestésica, realizada porunmédico anestesiólogo, se llevaacabo varios días antesdeunaintervención quirúrgica programada.Es útil que el paciente complete un cuestionario antes de esta consulta.
Los principales objetivos de la consulta preanestésica son: obtener información sobre los antecedentes del paciente, realizar la exploración clínica, seleccionar los exámenes complementarios e informar al paciente, particularmente en lo que se refiere a la técnica anestésica. La mayoría de los tratamientosmédicosseprosiguen hastala vísperaolamañanadel díadela intervención.Esimportante, sobre todoenelcasodelosmedicamentos cardiovasculares,cuyainterrupciónbruscapuededescompensarlaenfermedadqueseestátratando.Losfármacosqueinterfierenconlahemostasia (antigregantes plaquetarios y antivitaminas K) deben interrumpirse o sustituirse por heparina, en función de la indicación y del tipo de intervención. Los datos de la consulta se anotan en una hoja de anestesia, que se entrega en la historia clínica del paciente. Laconsultapreanestésicatambiéndebedetectarlaansiedadylostemoresdelpaciente.Laansiedadsecalmaconlaactitudempáticadelanestesiólogo, la información yunamedicación preanestésica.
La información, escrita y oral, debe referirse a la técnica anestésica, sobre todo en caso de anestesia locorregional, a los eventuales incidentes y accidentes, a la transfusión y al tratamiento del dolor postoperatorio. La satisfacción del paciente es muy difícil de valorar y depende tanto de la calidad de los actos técnicos como de los factores relativos a la organización y al entorno. La prescripción de exámenes complementarios no debe ser sistemática, sino que debe tener en cuenta la edad del paciente, su estado clínico y la naturaleza de la intervención.
Durante la consulta se dan al paciente instrucciones preoperatorias sobre la toma de medicamentos, el ayuno preoperatorio y las modalidades de la anestesia ambulatoria.
La clasificación del paciente según laAmerican Society ofAnesthesiologists (clasificaciónASA)forma parte de la evaluación del riesgo anestésico.


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