Suggested Pre-Referral Evaluation and Management Guidelines
Adults having elective operations at the University of Michigan.
Patients referred to the preoperative anesthesia assessment clinic will be reviewed by an anesthesia faculty who will determine if a patient needs to be scheduled for an appointment in the preoperative anesthesia clinic.
Preoperative anesthesia assessment clinic is not a walk-in clinic.
Clinic hours are Monday-Friday 9AM-4PM.
Please contact 936-3604 or 647-9975 with any scheduling questions.
Patients who should have a preoperative Anesthesia clinic request for review:
Patients with mild chronic medical problems (not functionally debilitating, generally American Society of Anesthesiologists class 2) may need a preoperative visit if there is a question as to whether their medical problems are well optimized. (ASA class 2 [Mild disease that causes no regular symptoms or limitations, i.e., well controlled hypertension])
Patients with significant medical disease (functionally debilitating; generally ASA class 3 patients) require a preoperative anesthesia evaluation. (American Society of Anesthesiologists class 3 = Disease that will regularly cause symptoms or limitations i.e., stable angina pectoris)
Patients with a history of anesthesia problems or complications
Patients with significant anxiety or questions regarding their anesthetic
Patients who DO NOT need a preoperative anesthesia clinic review:
Healthy patients without chronic medical problems (American Society of Anesthesiologists class 1 [Healthy--no medical issues]) who are having uncomplicated procedures
Patients with chronic medical conditions which are under optimal medical control (American Society of Anesthesiologists class 2 [Mild disease that causes no regular symptoms or limitations, i.e., well controlled hypertension])
Patients who have had a preoperative anesthesia evaluation with surgery re-scheduled to a later date may be updated on the day of the procedure unless a significant change in their medical status has occurred in the interim. Similarly, patients who require multiple operations, but have unchanging general medical status, do not need repeat visits to the preoperative anesthesia clinic.
Suggested Additional Test/Management Prior to Specialty Visit
Males >45 years old, females >55 years old:
ECG if none done within past year.
Patients with heart disease, signs or symptoms:
ECG if none done within past year
Patients with known pulmonary disease, signs or symptoms:
Chest x-ray if none done within past year
Patients with liver disease:
AST, ALT, electrolytes, PT, PTT, HCT, PLTs
Patients with renal disease:
Electrolytes, BUN, SCr, BUN, HCT, PLTs
Patient Education/Information (includes preps)
For patients for whom it is determined by the anesthesia faculty reviewing each case that preoperative anesthesia clinic appointment is necessary, we will make every effort to schedule the appointment on the same day as their surgical history and physical.
If there is any question regarding timing, propriety or patient convenience, please call the clinic at 647-9975 or 936-3604.
How to Get Results to Consultant
UMHS Patients: See MiChart
External Patients: Hand carry non-UM records to visit
Clinic Contact Information
Patient: 734-647-9975 or 734-936-3604