Prophylactic beta-blockage for non-cardiac surgery reduces the incidence of postoperative myocardial infarction and supraventricular arrhythmias, but may potentially increase stroke, hypotension, bradycardia and even death. The beneficial effects seem to be cardiac-risk related, and are only seen in those with moderate to high cardiac risk. Current evidence supports continuing beta-blockers in the perioperative period in those who are chronically on beta-blockers and to prescribe beta-blockers for high-risk patients with coronary artery disease undergoing high risk non-cardiac operations. (1B)

Long-acting anxiolytics should be avoided, especially in the elderly, while short acting drugs may be used to reduce preoperative anxiety. (2B)

Nutritional assessment should be undertaken in all patients with a view to detecting and optimizing nutritional status before surgery. (1C)

Patients undergoing esophagectomy, and their family or care taker, should receive pre-operative counseling with emphasis on perioperative and postoperative targets and goals. (1C)

Smoking should be stopped 4 weeks prior to surgery and regular high alcohol consumers should abstain at least 4 weeks before surgery to reduce postoperative complications. (1C)

CPET results have been used to assess patients undergoing major surgery, to guide preoperative optimization, to predict postoperative cardiopulmonary complications after surgery and, in some centers, to assess whether borderline patients should undergo resection. Evidence in support of the use of exercise derived parameters in risk stratification of esophageal resection patients is currently limited. (2C)

We suggest that whatever technique is used for interscalene BPB, the minimum success rate compatible with expert practice is 95% and the maximum total incidence of complication should be no more than 7%. (2C)

We suggest that ultrasound guidance is used for interscalene brachial plexus block because of its theoretical advantages, its high success rates and evidence that it requires fewer needle passes and lower volumes of local anaesthetic agent. There is evidence that ultrasound guidance does not increase harm and it may be associated with a reduced rate of complications. (2C)

We recommend that ultrasound guidance is used for supraclavicular brachial plexus block because of its theoretical advantages and evidence for its reduced risk of inadequate block. There is evidence that ultrasound guidance does not increase harm and it may be associated with a reduced rate of complications, the incidence of which is low. (1C)

We suggest that whatever technique is used for supraclavicular BPB, the minimum success rate compatible with expert practice is 86% and the total incidence of pneumothorax or vascular puncture should be no more than 1%. (2C)