Implantação do Serviço de Avaliação Pré-Anestésica em Hospital Universitário: dificuldades e resultados

Flora Margarida Barra Bisinotto; Maurício Pedrini Júnior; Alírio Alex Rosa Alves; Maria Abadia Pereira Roso Andrade

doi:10.1590/S0034-70942007000200005

Artigo Científico

Implantação do Serviço de Avaliação Pré-Anestésica em Hospital Universitário: dificuldades e resultados

Implementation of a Preanesthetic Evaluation Service in a University Hospital: difficulties and results

Flora Margarida Barra Bisinotto; Maurício Pedrini Júnior; Alírio Alex Rosa Alves; Maria Abadia Pereira Roso Andrade

http://dx.doi.org/10.1590/S0034-70942007000200005 Braz J Anesthesiol, vol.57, n2, p.167-176, 2007

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Resumo

JUSTIFICATIVA E OBJETIVOS: A avaliação pré-operatória é a chave principal para um bom preparo pré-operatório e manuseio intra-operatório. Quando realizada em nível ambulatorial permite uma análise melhor, possibilitando investigações adicionais, melhorando a qualidade do preparo e diminuindo os custos hospitalares. O objetivo deste estudo foi analisar a implantação e o desenvolvimento do Serviço de Avaliação Pré-Anestésica (SAPAN) em Hospital Universitário, verificando quais foram as dificuldades e os resultados positivos encontrados. MÉTODO: Foram avaliados os dados relativos aos pacientes atendidos no ambulatório do SAPAN, pelos médicos em especialização com supervisão de um docente, nos primeiros nove meses de instalação. A consulta era feita seguindo uma ficha padronizada. Ao término, os pacientes eram liberados para o procedimento cirúrgico ou encaminhados para consulta com outros especialistas para controle de doenças específicas. Analisou-se o número de pacientes avaliados e o número de procedimentos cirúrgicos eletivos realizados nesse período e as diversas especialidades cirúrgicas, porcentagem de pacientes com intervenção cirúrgica suspensa por necessidade de controle de doenças, e as especialidades clínicas mais solicitadas. RESULTADOS: Realizaram-se 913 consultas ambulatoriais e 5.409 intervenções cirúrgicas eletivas. Várias clínicas não encaminharam seus pacientes para a avaliação. Por necessidade clínica, 11,9% dos pacientes tiveram o procedimento cirúrgico suspenso, e as clínicas envolvidas foram cardiologia (43,08%), pneumologia (25,74%), hematologia (21,65%) e endocrinologia (9,52%). CONCLUSÕES: Embora grande parte dos pacientes não tenha sido encaminhada pelas especialidades cirúrgicas, os dados iniciais do SAPAN permitiram demonstrar os benefícios de um serviço de preparo ambulatorial dos pacientes.

Palavras-chave

AVALIAÇÃO PRÉ-ANESTÉSICA

Abstract

BACKGROUND AND OBJECTIVES: Preoperative evaluation is the key for a good preoperative preparation and intraoperative handling. When done in the outpatient clinic, it allows for better analysis and further investigation, improving the quality of the preparation and decreasing hospital costs. The aim of this study was to analyze the implementation of the Serviço de Avaliação Pré-Anestésica (SAPAN Preanesthetic - Service) in a University Hospital, and to determine the difficulties and positive results. METHODS: The data regarding patients seen at the SAPAN clinic, by the residents, under the supervision of an attending physician, in the first nine months after its implementation was reviewed. The consultation followed a standard form. At the end of the preanesthetic evaluation, patients were either cleared for surgery or referred to other specialties for the treatment of specific diseases. The items analyzed were: number of patients evaluated, number of elective surgeries performed during this period, surgical specialties involved, percentage of patients whose surgeries were cancelled due to the need to control underlying diseases, and clinical specialties requested the most to evaluate and treat those patients. RESULTS: Nine hundred and thirteen outpatient consultations and 5,409 elective surgeries were performed. In 11.9% of the cases, the surgeries were cancelled for medical reasons, and the most frequent specialties involved were cardiology (43.08%), pneumology (25.74%), hematology (21.65%), and endocrinology (9.52%). CONCLUSIONS: Although the majority of patients was not referred by the surgical specialties, the initial SAPAN data demonstrated the benefits of a preanesthetic evaluation service.

Keywords

PREANESTHETIC EVALUATION

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Implantação do Serviço de Avaliação Pré-Anestésica em Hospital Universitário: dificuldades e resultados

Implementation of a Preanesthetic Evaluation Service in a University Hospital: difficulties and results

Flora Margarida Barra Bisinotto; Maurício Pedrini Júnior; Alírio Alex Rosa Alves; Maria Abadia Pereira Roso Andrade

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