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Thursday, July 15, 2010


Do you think the PAC clinics have started disappearing? Are they essential for pre anaesthetic evaluation? This issue has recently been emerged as a topic for discussion in some Anaesthesia conference. Eventhough at first thought,  you may feel this is an absurd statement,those who support this notion give some valid reasons. They strongly argue that ASA 1 and 2 patients are not benefitted from PAC as they are in good health or in mild systemic illness which is well controlled.These patients can be directly admitted to the ward by surgeons or they can report as day care cases, which will reduce the work strain of staff and doctors and  that this is cost effective.This method also helps to reduce the waiting time of patients in PAC clinic. For ASA 3 and 4 pre anaesthetic check up and follow up are done in ward  on a multidisciplinary approach.

The author somehow feels this is inappropriate. A well conducted PAC clinic is essential for the proper assessment of all types of patients including ASA 1 and 2. Now office based  and day care surgeries are commonplace everywhere and patients seen in PAC clinic can be sent to office or day care suite direct,on the day of surgery without getting them admitted to the hospital.Even in a properly conducted preanaesthetic check up, the clinician missed certain vital informations in ASA 1 and 2 cases, which led to serious intra operative complications.Thus the  necessity of a thorough and proper evaluation aided by available investigations is stressed.. Look into some of the following clinical scenario.