Step 3: Patient Preparation
The patient should be stabilized before anesthesia as anesthesia and surgery can exacerbate pre-existing physiologic compromise. Stabilization is patient-specific and includes acute (e.g., immediate preoperative IV fluid administration and analgesia) and chronic (e.g., initiation of treatment for cardiac disease, with anesthesia rescheduled after 2–4 wk of therapy) stabilization. An accurate patient weight should be obtained on the day of anesthesia. All drug doses should be based on the patient’s lean bodyweight, as fat bodyweight contributes little to volume of distribution and hence should add little to the anesthesia dose. Preparation of an anesthesia record and patient-specific emergency drug calculations are important steps in preparing for potential anesthetic complications. In almost all situations, placement of an IV catheter is optimal anesthetic patient care as the catheter allows for administration of additional anesthetics, analgesic drugs, and fluids, along with administration of emergency medication drugs, if needed. Patients undergoing very short procedures do not necessarily require fluids yet still benefit from an IV catheter.