Pre-assessment and pre-optimisation of the surgical patient

The key aim of ERAS is to ensure that surgical patients “feel better sooner and are able to return to normal living sooner”. The pre-operative period is immensely valuable in helping achieving these goals for a number of reasons. This review article will highlight some of key areas where pre-operative assessment is involved in ensuring the surgical patient is optimally prepared for their surgery, in particular those patients that might be high risk and have multiple co-morbidites. The focus of this particular article will be the management of some common chronic conditions, including anaemia and diabetes, and how these can be optimised in the pre-operative period, as well as discuss the concept of prehabilitation and its role within an ERAS programme.