Pre-Anaesthesia Assessments of Adults Undergoing Elective Surgery: A Scoping Review

Introduction: Pre-anaesthesia (PA) assessments aim to ensure that anaesthesia is administered as safely and efficiently as possible, minimising risks and improving patient care. While the goal remains the same, the content, delivery, setup and evaluation of PA assessments have evolved over the years, driven by technological opportunities and healthcare systems' needs. Hence, the objective of this study was to systematically review and map the literature regarding pre-anaesthesia approaches and outcomes. Method: A scoping review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews checklist, using the five main steps described by Arksey and O'Malley and refined by Levac. Results: Of the initial 3909 studies, 383 in full-text were assessed for eligibility, resulting in 112 included studies. The studies were conducted from 1979 onwards, across more than 35 countries. These data represented 369,709 aggregate patients and 2522 healthcare professionals. Common themes amongst the included studies were implementation of a PA clinic, reduction of cancellation rates, information and teaching activities (both patients and clinicians), and optimisation and improvement of the PA assessment using information technology. Conclusion: This review highlights the evolving nature of PA practices, shaped by diverse historical and clinical contexts. While many efforts have aimed to improve efficiency, reduce cancellations and enhance safety and satisfaction, emerging technologies offer new potential to further streamline assessments. Despite extensive focus on patient education, active patient involvement in the PA process remains underexplored. A forward-looking strategy should integrate flexible, personalised elements—such as frailty scoring—while fostering patient engagement and shared decision-making to optimise outcomes.