Impact of outpatient preanesthetic consultation on perioperative outcomes in 700 urological patients in a tertiary hospital: a retrospective observational study.

BACKGROUND

Outpatient preanesthetic consultation improves patient assessment and anesthetic planning, enhancing safety and reducing complications. Conducted in advance, it allows systematic, individualized planning. Uncontrolled hypertension, common in 60% of people over 60, is a major cause of surgery cancellation and increases cardiovascular risk. This study evaluates its impact on preventing perioperative complications and optimizing clinical and surgical outcomes in urological patients.

METHODS

This retrospective observational study analyzed 700 patients (≥ 18 years) who attended outpatient preanesthetic consultation before urological surgery. Clinical conditions, systemic blood pressure, heart rate was analyzed during outpatient, preoperative, and intraoperative periods. Preoperative and intraoperative complications were recorded to evaluate consultation impact.

RESULTS

Among 700 patients (89.6% male, mean age 64.2), ASA II was most common classification. Hypertension was identified in 53.7% of patients during outpatient evaluation. All hypertensive patients received antihypertensive treatment until surgery, with blood pressure maintained within normal limits. Preoperative findings in the operating room included hypertension (2.0%), anemia (0.57%), atrial fibrillation (0.14%), and asthma (0.14%). Intraoperative events included hypertension (2.28%), hypotension (8.14%), bradycardia (1.14%), and inadequate neuraxial block (2.85%). One surgery was canceled due to hypertension. Blood pressure significantly decreased preoperatively and intraoperatively compared to outpatient values (p < 0.0001). Heart rate also decreased significantly intraoperatively. This single-center study has limitations, including absence of comparison groups assessed by other specialties or only day of surgery.

CONCLUSION

Reductions in systolic and diastolic blood pressure were documented upon operating room entry among patients evaluated in outpatient preanesthetic consultation, with a very low surgery cancellation rate.