From the Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.
Department of Clinical Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania.
Anesth Analg. 2022 Mar 1;134(3):466-474. doi: 10.1213/ANE.0000000000005877.
In this Pro-Con commentary article, we discuss the models, value propositions, and opportunities of preoperative clinics run by anesthesiologists versus hospitalists and their role in perioperative care. The medical and anesthesia evaluation before surgery has pivoted from the model of "clearance" to the model of risk assessment, preparation, and optimization of medical and psychosocial risk factors. Assessment of these risk factors, optimization, and care coordination in the preoperative period has expanded the roles of anesthesiologists and hospitalists as members of the perioperative care team. There is ongoing debate regarding which model of preoperative assessment provides the most optimal preparation for the patient undergoing surgery. This article hopes to shed light on this debate with the data and perspectives on these care models.
在这篇正反双方观点的评论文章中，我们讨论了由麻醉师和医院医师运营的术前诊所的模式、价值主张和机会，以及它们在围手术期护理中的作用。手术前的医学和麻醉评估已经从“清除”模式转变为风险评估、准备和优化医疗和社会心理风险因素的模式。对这些风险因素的评估、优化和术前护理协调已经扩大了麻醉师和医院医师作为围手术期护理团队成员的角色。关于哪种术前评估模式为手术患者提供了最佳准备，目前仍存在争议。本文希望通过这些护理模式的数据和观点来阐明这一争议。
