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

Silvana Lellouche de Castro; Alexandra Rezende Assad; Aline d’Avila; Camila Spiller; René Murilo de Oliveira; Ismar L. Cavalcanti; Nubia Verçosa

doi:10.1016/j.bjane.2026.844743

Original Investigation

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

Impacto da consulta pré-anestésica ambulatorial nos desfechos perioperatórios em 700 pacientes urológicos em um hospital terciário: estudo observacional retrospectivo

Silvana Lellouche de Castro, Alexandra Rezende Assad, Aline d’Avila, Camila Spiller, René Murilo de Oliveira, Ismar L. Cavalcanti, Nubia Verçosa

http://dx.doi.org/10.1016/j.bjane.2026.844743 Braz J Anesthesiol, vol.76, n3, 844743, 2026

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Abstract

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.

Keywords

Ambulatory care; Observational study; Perioperative medicine; Preoperative care; Urological diseases

Resumo

Introdução

A consulta pré-anestésica ambulatorial melhora a avaliação do paciente e o planejamento anestésico, aumentando a segurança e reduzindo complicações. Realizada previamente ao procedimento, permite planejamento sistemático e individualizado. A hipertensão arterial não controlada, comum em 60% das pessoas acima de 60 anos, é uma das principais causas de cancelamento cirúrgico e aumenta o risco cardiovascular. Este estudo avalia seu impacto na prevenção de complicações perioperatórias e na otimização de desfechos clínicos e cirúrgicos em pacientes urológicos.

Métodos

Este estudo observacional retrospectivo analisou 700 pacientes (≥ 18 anos) que realizaram consulta pré-anestésica ambulatorial antes de cirurgia urológica. Condições clínicas, pressão arterial sistêmica e frequência cardíaca foram analisadas nos períodos ambulatorial, pré-operatório e intraoperatório. Complicações pré-operatórias e intraoperatórias foram registradas para avaliar o impacto da consulta.

Resultados

Entre os 700 pacientes (89,6% homens, idade média 64,2 anos), a classificação ASA II foi a mais comum. Hipertensão foi identificada em 53,7% dos pacientes durante a avaliação ambulatorial. Todos os pacientes hipertensos receberam tratamento anti-hipertensivo até a cirurgia, com manutenção da pressão arterial dentro dos limites normais. Achados pré-operatórios na sala cirúrgica incluíram hipertensão (2,0%), anemia (0,57%), fibrilação atrial (0,14%) e asma (0,14%). Eventos intraoperatórios incluíram hipertensão (2,28%), hipotensão (8,14%), bradicardia (1,14%) e bloqueio neuraxial inadequado (2,85%). Uma cirurgia foi cancelada devido à hipertensão. Houve redução significativa da pressão arterial sistólica e diastólica na admissão na sala cirúrgica e no intraoperatório em comparação aos valores ambulatoriais (p < 0,0001). A frequência cardíaca também reduziu significativamente no intraoperatório. Este estudo unicêntrico apresenta limitações, incluindo ausência de grupo comparativo avaliado por outras especialidades ou apenas no dia da cirurgia.

Conclusão

Foram documentadas reduções na pressão arterial sistólica e diastólica na entrada da sala cirúrgica em pacientes avaliados em consulta pré-anestésica ambulatorial, com taxa muito baixa de cancelamento cirúrgico.

Palavras-chave

Cuidado ambulatorial; Estudo observacional; Medicina perioperatória; Cuidados pré-operatórios; Doenças urológicas

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Submitted date:
05/25/2025

Accepted date:
02/23/2026