Perioperative medicine

Our Department of Anaesthesia delivers specialist perioperative services. This includes a Pre-anaesthetic Assessment Clinic (PAC), Cardiopulmonary Exercise Testing, and a Pre-habilitation program

You will meet with various members of the Perioperative medicine team when referred to us. These members include Clerical staff, Pharmacists, Dieticians, Perioperative Nurse Specialists and Anaesthetists.

The tumour stream will start the referral pathway for you with us as follows: 

  1. You will attend specialist clinics. You will also complete the Health Assessment Questionnaire (HAQ) and booking forms. The surgical team will order Pathology/electrocardiogram (ECG). 

  2. Outpatient pathology visit for collection of ECG and pathology. 

  3. You will visit PAC for further assessment. 

The goals of the clinic are: 

  • To assess patients on time before their date of surgery. 

  • To organize any necessary investigations and review those already performed. 

  • To cater for any pre-existing medical conditions and check medication scheduling. This enhances the safety of patients coming for surgery. 

  • To discuss the anaesthetic plan, associated risks and discuss consent. The PAC serves you and your family. It lets you ask questions and voice concerns about the surgery's proposed anaesthetic. 

We achieve this through a comprehensive medical history and examination. We may sometimes refer patients for a specialist physician review. These specialists can include Cardiologists or Respiratory physicians. We may also refer patients for more specific investigations. This could include an Echocardiogram. Such investigations help further guide anaesthetic management. 

The PAC runs four days a week, Monday to Thursday from 10am to 5pm. 

Perioperative medicine contact 

Specialist clinics 

Phone: (03) 8559 5555 

Perioperative medicine location 

Specialist clinics 

Level 2 
305 Grattan Street 
Melbourne VIC 3000 

Cardiopulmonary exercise testing (CPET) and pre-habilitation 

You may be undergoing high-risk surgery. Or, you may have a significant cardiac or respiratory disease. If so, we will refer you for CPET testing at the VCCC. CPET is a reliable and fair test for evaluation of your functional ability. We measure the performance of your heart and lungs during rest and exercise. We then check the results. These results generate valuable information for the anaesthetic and surgical teams. The results also aid preoperative risk stratification. We then refer patients for pre-habilitation in order to optimise their physical condition prior to surgery. 

Find out more about cardiopulmonary exercise testing. 

Intraoperative care 

Your intraoperative care begins with the transfer into theatre. It ends when you enter the Post-Anesthetic Care Unit (PACU). Surgical, anaesthetic and theatre staff work together. They help ensure your safety. Advanced monitoring techniques, directed therapy and consistent standards of care, aid the safe administration of anaesthesia.  We continue to assess and monitor you after the operation, in PACU. This ensures you are safe, stable, and comfortable. We then transfer you to the ward or second level recovery. 

Acute pain service 

The acute pain service offers specialist advice, management of and treatment for pain. After appropriate referral, a member of the APS team will review you on time, every day. Only then will we discharge you from the APS. Options for pain-relief include  

  • multi-modal oral analgesics 

  • regional anaesthesia 

  • neauraxial blocks (for example, Epidurals)  

  • patient-controlled analgesia (PCA).  

The transition from the immediate post-operative period to a planned analgesic regimen varies. The transition is specific to an individual patient and the surgical requirements. The team are on call to help, supply advice, and review as necessary 24 hours a day, seven days a week. 

Find out more about the acute pain service

Related links

What is perioperative medicine?

Pages related to perioperative medicine