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Chapter 2.10 - Perioperative Medicine

from Section 2 - Surgery

Published online by Cambridge University Press:  26 May 2025

Edited by
Rebecca Leslie ,
Emily Johnson ,
Gary Thomas  and
Philip Harrington
Rebecca Leslie
Affiliation:
Royal United Hospitals NHS Foundation Trust, Bath
Emily Johnson
Affiliation:
Worcester Acute Hospitals NHS Trust, Worcester
Gary Thomas
Affiliation:
Cwm Taf Morgannwg University Health Board, Bridgend
Philip Harrington
Affiliation:
West Midlands Deanery, Birmingham
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Summary

Cardiopulmonary exercise testing (CPET) is a non-invasive, dynamic assessment of the cardiopulmonary system at rest and during exercise. It provides an objective assessment of an individual’s functional capacity, that is the ability to respond to the increased metabolic demand associated with major surgery. This information can help to estimate the risk of perioperative morbidity and mortality as well as assist clinicians in the decision-making process between surgical and non-surgical management of the patient. The outcome of this preoperative investigation may also inform surgical consent, planning and optimisation of a patient in preparation for their operation.

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Dr Podcast Scripts for the Final FRCA , pp. 453 - 472
Publisher: Cambridge University Press
Print publication year: 2025

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References

Further Reading

Agnew, N. Preoperative cardiopulmonary exercise testing. BJA Education. 2010; 10: 33–37.Google Scholar
Chambers, DJ, Wisely, NA. Cardiopulmonary exercise testing: A beginner’s guide to the 9-panel plot. BJA Education. 2019; 19: 158–164.CrossRefGoogle Scholar
Levett, DJH, Jack, S, Swart, M, et al. Perioperative cardiopulmonary exercise testing (CPET): Consensus clinical guidelines on indications, organisation, conduct, and physiological interpretation. British Journal of Anaesthesia. 2018; 120: 484–500.CrossRefGoogle ScholarPubMed

Further Reading

Association of Anaesthetists of Great Britain and Ireland. Pre-operative Assessment and Patient Preparation The Role of The Anaesthetist. AAGBI Safety Guideline 2010. https://anaesthetists.org/Home/Resources-publications/Guidelines/Pre-operative-assessment-and-patient-preparation-the-role-of-the-anaesthetist-2/.Google Scholar
Banugo, P, Amoako, D. Prehabilitation. British Journal of Anaesthesia. 2017; 17: 401–405.Google Scholar
Fawcett, W, Ljungqvist, O. Starvation, carbohydrate loading, and outcome after major surgery. British Journal of Anaesthesia. 2017; 17: 312–316.Google Scholar
Schonborn, JL, Anderson, H. Perioperative medicine: A changing model of care. British Journal of Anaesthesia. 2019; 19: 27–33.Google ScholarPubMed
Stones, J, Yates, D. Clinical risk assessment tools in anaesthesia. British Journal of Anaesthesia. 2019; 19: 47–53.Google ScholarPubMed
Wong, DJN, Harris, S, Sahni, A, et al. Developing and validating subjective and objective risk-assessment measures for predicting mortality after major surgery: An international prospective cohort study. PLoS Med. 2020; 17: e1003253.CrossRefGoogle ScholarPubMed
Yentis, S, Hirsch, N, Ip, J. 2019. Anaesthesia, Intensive Care and Perioperative Medicine A-Z. 6th ed. Elsevier.Google Scholar

Further Reading

British Thoracic Society Guideline for oxygen use in adults in healthcare and emergency settings. Thorax. 2017; 72:i1–i90.CrossRefGoogle Scholar
Evans, MT, Wigmore, T, Kelliher, LJ. The impact of anaesthetic technique upon outcome in oncological surgery. British Journal of Anaesthesia Education. 2019; 19(1): 14–20.Google ScholarPubMed
Jones, GL, Will, A, Jackson, GH, Webb, NJ, Rule, S. Guidelines for the management of tumour lysis syndrome in adults and children with haematological malignancies on behalf of the British Committee for Standards in Haematology. British Journal of Haematology. 2015; 169(5): 661–671.CrossRefGoogle Scholar
National Institute for Health and Clinical Excellence. Colorectal Cancer. 2020 www.nice.org.uk/guidance/ng151/chapter/Recommendations#management-of-local-diseaseGoogle Scholar
Sessler, D, Pei, L, Huang, Y, Fleischmann, E, Marhofer, P, Kurz, A, et al. Recurrence of breast cancer after regional or general anaesthesia: A randomised controlled trial. The Lancet. 2019; 394(10211): 1807–1815.CrossRefGoogle ScholarPubMed

Further Reading

Alcorn, S, Foo, I. Perioperative management of patients with dementia. British Journal of Anaesthesia. 2017; 17: 94–98.Google Scholar
Allman, K, Wilson, I. 2016. Oxford Handbook of Anaesthesia. 4th ed. Oxford University Press.CrossRefGoogle Scholar
Association of Anaesthetists of Great Britain and Ireland. Peri-operative care of the elderly 2014. Anaesthesia. 2014; 69: 81–98.CrossRefGoogle Scholar
Brodier, EA, Cibelli, M. Postoperative cognitive dysfunction in clinical practice. British Journal of Anaesthesia. 2021; 21: 75–82.Google ScholarPubMed
Cibelli, M. Becoming confused after an operation. Royal College of Anaesthetists. 2017. www.rcoa.ac.uk/sites/default/files/documents/2019-07/07-Confused2017.pdf.Google Scholar
Evers, A, Maze, M, Kharasch, E. 2011. Anesthetic Pharmacology. Basic Principles and Clinical Practice. 2nd ed. Cambridge University Press.Google Scholar
Griffiths, R, Mehta, M. Frailty and anaesthesia: What we need to know. Continuing Education in Anaesthesia Critical Care and Pain. 2014; 4: 273–277.CrossRefGoogle Scholar
Hacking, R, O’Connor, D. Anatomy and physiology of ageing. Anaesthesia Tutorial of the Week 2008. https://resources.wfsahq.org/atotw/anatomy-and-physiology-of-ageing/.Google Scholar
Hollister, N. Anaesthesia in the elderly. Anaesthesia Tutorial of the Week 2006. https://resources.wfsahq.org/atotw/anaesthesia-in-the-elderly/Google Scholar
Murray, D, Dodds, C. Perioperative care of the elderly. Continuing Education in Anaesthesia Critical Care and Pain 2004; 4: 193–196.CrossRefGoogle Scholar
Pang, CL, Gooneratne, M, Partridge, JSL. Preoperative assessment of the older patient. British Journal of Anaesthesia. 2021; 21: 314–320.Google ScholarPubMed
Tan, A, Amoako, D. Postoperative cognitive dysfunction after cardiac surgery. British Journal of Anaesthesia. 2013; 3: 218–223.Google Scholar
Yentis, S, Hirsch, N, Ip, J. 2019. Anaesthesia, Intensive Care and Perioperative Medicine A-Z. 6th ed. Elsevier.Google Scholar

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  • Perioperative Medicine
  • Edited by Rebecca Leslie, Royal United Hospitals NHS Foundation Trust, Bath, Emily Johnson, Worcester Acute Hospitals NHS Trust, Worcester, Gary Thomas, Cwm Taf Morgannwg University Health Board, Bridgend, Philip Harrington, West Midlands Deanery, Birmingham
  • Book: Dr Podcast Scripts for the Final FRCA
  • Online publication: 26 May 2025
  • Chapter DOI: https://doi.org/10.1017/9781009267441.020
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  • Perioperative Medicine
  • Edited by Rebecca Leslie, Royal United Hospitals NHS Foundation Trust, Bath, Emily Johnson, Worcester Acute Hospitals NHS Trust, Worcester, Gary Thomas, Cwm Taf Morgannwg University Health Board, Bridgend, Philip Harrington, West Midlands Deanery, Birmingham
  • Book: Dr Podcast Scripts for the Final FRCA
  • Online publication: 26 May 2025
  • Chapter DOI: https://doi.org/10.1017/9781009267441.020
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Perioperative Medicine
  • Edited by Rebecca Leslie, Royal United Hospitals NHS Foundation Trust, Bath, Emily Johnson, Worcester Acute Hospitals NHS Trust, Worcester, Gary Thomas, Cwm Taf Morgannwg University Health Board, Bridgend, Philip Harrington, West Midlands Deanery, Birmingham
  • Book: Dr Podcast Scripts for the Final FRCA
  • Online publication: 26 May 2025
  • Chapter DOI: https://doi.org/10.1017/9781009267441.020
Available formats
×