The specific contents are as follows: improve the patient's nutritional status; correct severe anemia, water and electrolyte acid-base disorders and hypoalbuminemia; stop smoking; increase physical strength; practice deep breathing, improve cardiopulmonary reserve function, etc.

Differences of opinion may arise during the preparation for anesthesia, and consensus should be reached through consultation based on the principle of “what is best for the patient.”

The key is to improve heart function

For those who have acute respiratory infection before surgery, unless it is an emergency, the surgery should be suspended and the infection should be fully controlled for one week before surgery, otherwise the postoperative respiratory complications will be significantly increased.

Patients with coexisting chronic respiratory diseases such as asthma, chronic obstructive pulmonary disease, bronchiectasis, etc. ① Pulmonary function, arterial blood gas analysis and X-ray chest X-ray should be checked before surgery; ② Stop smoking for at least 2 weeks and perform respiratory function training; ③ Perform aerosol inhalation and chest physical therapy to promote phlegm excretion; ④ Use bronchodilators and adrenocortical hormones before surgery; ⑤Effective antibiotic treatment for ~5 days to control acute and chronic pulmonary infections, and improve the patient's respiratory reserve function through complete preoperative preparation

Preparatory work before anesthesia must be done based on the original disease, condition and degree of change.

Hyperthyroidism patients

Patients with primary aldosteronism and hypercortisolism

Pheochromocytoma patients

diabetic patient

Patients with mild hepatic insufficiency have little impact on their ability to tolerate anesthesia and surgery; In moderate hepatic insufficiency or on the verge of decompensation, tolerance to anesthesia and surgery is significantly reduced. It requires a long period of preparation before surgery, active liver protection treatment, and maximum improvement of liver function and systemic condition before elective surgery; Severe hepatic insufficiency, such as advanced cirrhosis, often coexists with signs such as severe malnutrition, weight loss, anemia, hypoalbuminemia, large amounts of ascites, coagulation dysfunction, systemic bleeding, or early stage of hepatic encephalopathy, so the risk of surgical anesthesia is extremely high.

Except for emergency rescue surgery, patients with acute hepatitis are generally contraindicated in surgery.

Urinalysis (blood, sugar, protein), blood urea nitrogen (BUN), serum creatinine value, endogenous creatinine clearance, urine concentration test and phenol red test are clinically valuable functional tests.

With the application of preoperative blood analysis, renal failure is no longer a contraindication for elective surgery.

Preoperative preparation should maximize renal function, and if dialysis is required, it should be performed within 24 hours of the planned surgery.

For abnormal blood routine and coagulation caused by various reasons before surgery, the reasons should be clarified and given before anesthesia. Treat the cause accordingly and prepare blood component products. Generally, adult surgery requires Hb>80g/L, PLT>50×/10 9/L

Patients planning to undergo neuraxial anesthesia should have routine checks on spine and spinal cord function

Patients with obstructive sleep apnea syndrome need to undergo pulmonary function testing and arterial blood gas analysis before surgery, and pay attention to the increase in PaC02 in the resting period (postoperative pulmonary complications are significantly increased);

For patients with acute alcohol poisoning caused by accidental heavy drinking, if emergency surgery is required, the specificity will not be increased, but the requirement for anesthetics may be significantly reduced, so medication should be used rationally as appropriate to avoid overdose.