Perioperative medicine

The Department of Anaesthesia at Peter Mac provides specialist perioperative services, including a Pre-anaesthetic Assessment Clinic (PAC), Cardiopulmonary Exercise Testing (CPET) and a Pre-habilitation program.

Pre-anaesthetic Clinic at Peter Mac at The Victorian Comprehensive Cancer Centre (VCCC)

If patients are referred to the clinic, they will meet with various members of the preoperative care team as appropriate – these include clerical staff, pharmacists, dieticians, perioperative nurse specialists and anaesthetists.

The referral pathway for patients at the VCCC will be initiated by the tumour stream as follows:

  • Step 1: Patient attends specialist clinics – Health Assessment Questionnaire (HAQ) and booking forms are completed. Pathology/electrocardiogram (ECG) are ordered by the surgical team.
  • Step 2: Outpatient pathology visit by patient for collection of ECG and pathology.
  • Step 3: Patient visits PAC for assessment.

The goals of the clinic are:

  • To assess patients in a timely manner prior to their date of surgery.
  • To organize any necessary investigations and review those already performed.
  • To optimize any co-morbidities and advise medication scheduling to enhance the safety of patients coming for surgery.
  • To discuss the anaesthetic plan, associated risks and obtain appropriate consent. The PAC provides an opportunity for the patient and their families to ask any questions and voice any concerns they may have regarding the proposed anaesthetic for their surgery.

This process is achieved through a comprehensive medical history and examination. Occasionally, patients may be referred for a specialist physician review (e.g. Cardiologist), or more specific investigations (e.g. an Echocardiogram) to guide anaesthetic management further.

Service times

The PAC operates 4 days a week, Monday to Thursday from 10:00 – 17:00.


Specialist clinics

Phone: 03 8559 5555


Specialist clinics

Level 2

305 Grattan Street

Melbourne VIC 3000

Cardiopulmonary exercise testing (CPET) and Pre-habilitation

Patients undergoing high-risk surgery, or who have significant cardiac or respiratory disease may be referred for CPET testing at the VCCC. CPET is a reliable and objective test for evaluation of a patient’s functional capacity. It involves measuring the performance of the heart and lungs during rest and exercise. The results are evaluated and can generate valuable information for the anaesthetic and surgical teams. The results aid preoperative risk stratification and appropriate referral for pre-habilitation of the surgical patient. 

Find out more about cardiopulmonary exercise testing.

Intraoperative Care

The intraoperative care of our patients begins with the transfer into theatre and ends when the patient enters the Post-Anesthetic Care Unit (PACU). Surgical, anaesthetic and theatre staff work together to ensure the safety of each patient. The safe administration of anaesthesia is aided by use of advanced monitoring techniques, goal directed therapy and consistently in standards of care.  Post-operatively, patients are assessed and monitored in PACU to ensure they are safe, stable and comfortable prior to transfer to the ward or second level recovery.

Acute Pain Service

The acute pain service (APS) offers specialist advice, management of and treatment for pain post-operatively. After appropriated referral, a member of the APS team will review patients in a timely manner, every day until they are able to be discharged from the APS. Options for pain-relief include multi-modal oral analgesics, regional anaesthesia, neauraxial blocks (e.g Epidurals) and patient-controlled analgesia (PCA). The transition from the immediate post-operative period to a planned analgesic regimen is specific to each individual patient and surgical requirements. The team are on-call to assist, advise and review as necessary 24 hours a day, 7 days a week.

For more information about our acute pain service.