Stopping and restarting medications in the perioperative period.

Medical consultants in the care of patients undergoing surgery have many tasks. One of these is to recommend the safest and most effective use of medication in the perioperative period. The physician must balance the urge to simplify with the need to maintain stability in the patient and his or her chronic diseases. The physician must consider the patient, the particulars of the patient's life, the patient's illnesses, and the patient's desires. At times, the physician can rely on well-supported data for guidance. Much of the time, however, the physician must operate on limited information and hunches about the best advice. Above all, the physician must communicate clearly with the patient, the surgeon, the anesthesiologist, and other members of the medical team to ensure a safe transition through surgery and return to good health.