Consultations and evaluations should be conducted for patients when it is anticipated that these measures will uncover or confirm health issues that could necessitate adjustments in anesthesia management or lower the risk of perioperative complications. Such measures may include recommendations for patients to quit smoking to reduce their surgical risk. Continuing chronic beta-blocker therapy matters, and initiating beta-blockers well before surgery, carefully titrated to heart rate and blood pressure, can decrease the likelihood of myocardial ischemia; starting them on the day of surgery increased stroke and death in the POISE trial and should be avoided. Starting statin therapy about 30 days before surgery has been shown to reduce the risk of cardiac complications during the procedure, with studies indicating a notable reduction in the risk of acute kidney injury related to surgery. Elective surgeries should be postponed to allow adequate time for the diagnosis and treatment of any such conditions. Specifically, patients who have had a recent myocardial infarction are usually recommended to delay elective surgeries for at least 60 days following the heart attack.
