Preoperative anaesthesia and other team meetings for complex cases: a narrative review

The conventional two-step process for surgical procedures – surgical followed by anaesthetic consultation - may not adequately address the needs of complex cases involving high-risk patients or procedures, leading to increased risks of adverse events. Although surgical team meetings (STM) and multidisciplinary team meetings (MDTM) were implemented many years ago, anaesthesia team meetings (ATM) have recently emerged as potential solutions to enhance perioperative management. We aim to systematically review and summarize the existing literature that reflects the main theoretical approaches, practices, effects, and clinical relevance of preoperative team meetings - with specific consideration to preoperative ATM - in managing difficult cases. We performed a narrative review of the literature (1980 – 2024) to identify studies focusing on the practice and the impact of preoperative meetings on patient outcomes, compliance with treatment plans, and teamwork quality. We provide here a qualitative synthesis of the findings. Fourteen studies were identified: 11 consider preoperative multidisciplinary team meeting (MDTM), 2 consider preoperative surgical team meeting (STM), and only one anaesthesia team meeting (ATM). There is currently not enough robust evidence that preoperative team meetings clearly improve hard patient's outcome parameters. And the place for ATM does not appear to have been studied to date. There is a need for well-designed studies to explore the impact of preoperative ATM on clinical practice improvement, quality of care, and patient outcomes.