Does preoperative point-of-care ultrasonography alter anesthetic management? A pilot study

Study objective To explore whether preoperative point-of-care ultrasound (PoCUS) examinations alter the anesthetic management of anesthesiologists. Design Single-arm, non-randomized pilot study. Setting Preoperative bays of a tertiary university hospital in America. Patients A total of 50 patients undergoing elective or urgent surgeries or procedures involving anesthesia were prospectively enrolled. Intervention A novel PoCUS protocol incorporating six windows: subcostal four-chamber, apical four-chamber, apical five-chamber, parasternal long-axis, parasternal short-axis, and gastric antrum. Measurements To determine whether the information discovered during PoCUS examinations changed the management plan of the patient created by the attending anesthesiologist, the frequency of management alterations was calculated. To determine whether any anesthesiologist served as a confounder and made or did not make anesthetic plan changes at a higher or lower rate than other anesthesiologists, a chi-square test of independence was conducted. Main results Overall, 43 cases (86%) involved no changes in anesthetic management or monitoring, while 7 cases (14%) involved at least one change. Two cases (4%) were delayed for further optimization, two cases (4%) involved a lower induction dose of anesthetic than what was previously planned, two cases (4%) involved the addition of an arterial line for additional hemodynamic monitoring, one case (2%) involved the addition of a vasopressor, and one case (2%) involved a change from a standard intubation to an RSI. There was no statistically-significant association between any anesthesiologist and management changes although the analysis was limited by sample size and sparse event counts ( p = .525, 99% CI [0.513, 0.538]). Conclusion Preoperative PoCUS scans resulted in anesthetic management changes in 14% of the patients in this non-randomized pilot study. Larger, randomized controlled trials should be conducted to confirm this finding and to explore whether these changes impact the incidence of adverse events. Portions of these findings were previously submitted as part of the author's PhD Dissertation to Faulkner University's ProQuest Dissertation Repository in March 2026.