Shared decision making is a collaborative process between clinicians and patients, which aims to select the most suitable management option based on both best available evidence and patient preferences. This article looks at the role of shared decision making in perioperative medicine.

The cardiovascular effects of beta blockers are widespread, so their use in the perioperative period ought to be beneficial, although this is not clear cut. This article discusses the evidence for and against the use of beta blockers perioperatively and gives guidance for best practice.

Anaemia is a common condition affecting approximately 30% of surgical patients, with iron deficiency being the leading cause (Musallam et al, 2011). The World Health Organization historically defined anaemia as a haemoglobin concentration of less than 120 g/litre for women and 130 g/litre for men. However, a more recent international consensus statement on management of perioperative anaemia has suggested using 130 g/litre for both men and women (Muñoz et al, 2017).

Enhanced recovery is a multimodal package of care intended to expedite recovery following surgery. Many units now having enhanced recovery for obstetric surgery as a standard of practice for elective caesarean deliveries. Early discharge (after 24 hours) for uncomplicated caesarean delivery is in keeping with National Institute for Health and Care Excellence guidance.

Alcohol is the most commonly consumed recreational drug in the UK – 56% of adults drink alcohol regularly and nearly 10% drink on 5 or more days a week. 1.6 million adults in the UK may have some level of alcohol dependence (Office for National Statistics, 2017).