Preoperative assessment for thoracic anaesthesia

Preoperative assessment of patients for thoracic surgery is a multidisciplinary process designed to offer appropriate surgical treatment with acceptable risk. UK guidelines for pulmonary resection associated with malignant disease involved review of available evidence concerning operative risk. Patients displaying cardiopulmonary physiological parameters above previously recommended threshold values remain classified as acceptable risk. However, less certainty exists about the utility of predicted postoperative pulmonary function values and preoperative performance status to confer unacceptable risk. These guidelines suggest a tri-partite risk assessment combining risks of operative mortality, perioperative adverse cardiac events and postoperative dyspnoea, to be discussed by the multidisciplinary team and with the patient.