title: Preoperative evaluation in infants and children: recommendations of the Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care (SARNePI).
abstract: BACKGROUND
  The preoperative assessment involves the process of evaluating the patient's clinical condition, which is intended to define the physical status classification, eligibility for anesthesia and the risks associated with it, thus providing elements to select the most appropriate and individualized anesthetic plan. The aim of this recommendation was provide a framework reference for the preoperative evaluation assessment of pediatric patients undergoing elective surgery or diagnostic/therapeutic procedures.
  
  
  METHODS
  We obtained evidence concerning pediatric preoperative evaluation from a systematic search of the electronic databases MEDLINE and Embase between January 1998 and February 2012. We used the format developed by the Italian Center for Evaluation of the Effectiveness of Health Care's scoring system for assessing the level of evidence and strength of recommendations.
  
  
  RESULTS
  We produce a set of consensus guidelines on the preoperative assessment and on the request for preoperative tests. A review of the existing literature supporting these recommendations is provided. In reaching consensus, emphasis was placed on the level of evidence, clinical relevance and the risk/benefit ratio.
  
  
  CONCLUSIONS
  Preoperative evaluation is mandatory before any diagnostic or therapeutic procedure that requires the use of anesthesia or sedation. The systematic prescription of complementary tests in children should be abandoned, and replaced by a selective and rational prescription, based on the patient history and clinical examination performed during the preoperative evaluation.
authors.affiliation: Dipartimento di Anestesia e Rianimazione 1, Fondazione IRCCS Policlinico S. Matteo, Università di Pavia, Pavia, Italy - Pablo.ingelmo@muhc.mcgill.ca.
authors.forename: G
authors.initials: G
authors.lastname: Serafini
authors.forename: P M
authors.initials: PM
authors.lastname: Ingelmo
authors.forename: M
authors.initials: M
authors.lastname: Astuto
authors.forename: S
authors.initials: S
authors.lastname: Baroncini
authors.forename: F
authors.initials: F
authors.lastname: Borrometi
authors.forename: L
authors.initials: L
authors.lastname: Bortone
authors.forename: C
authors.initials: C
authors.lastname: Ceschin
authors.forename: A
authors.initials: A
authors.lastname: Gentili
authors.forename: E
authors.initials: E
authors.lastname: Lampugnani
authors.forename: G
authors.initials: G
authors.lastname: Mangia
authors.forename: L
authors.initials: L
authors.lastname: Meneghini
authors.forename: C
authors.initials: C
authors.lastname: Minardi
authors.forename: G
authors.initials: G
authors.lastname: Montobbio
authors.forename: F
authors.initials: F
authors.lastname: Pinzoni
authors.forename: B
authors.initials: B
authors.lastname: Rosina
authors.forename: C
authors.initials: C
authors.lastname: Rossi
authors.forename: E
authors.initials: E
authors.lastname: Sahillioğlu
authors.forename: M
authors.initials: M
authors.lastname: Sammartino
authors.forename: R
authors.initials: R
authors.lastname: Sonzogni
authors.forename: V
authors.initials: V
authors.lastname: Sonzogni
authors.forename: S
authors.initials: S
authors.lastname: Tesoro
authors.forename: C
authors.initials: C
authors.lastname: Tognon
authors.forename: N
authors.initials: N
authors.lastname: Zadra
mesh_terms: D000758:Anesthesia; D002648:Child; D002675:Child, Preschool; D003422:Critical Care; D017558:Elective Surgical Procedures; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D011300:Preoperative Care / Q000592:standards*