Practice Advisory for Preanesthesia Evaluation

doi:10.1097/00000542-200202000-00037

Cited by 302 publications

(36 citation statements)

References 57 publications

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“…Further, while adverse events are higher in those patients with medical comorbidities, there is no benefit in providing routine testing to groups of patients with co-existing illness (Schein 2000). Reviews of the literature and practice guidelines related to routine pre-surgical testing support the finding that commonly performed preoperative laboratory tests in adults preparing for elective surgeries have generally low predictive value (ASA Task Force 2002; Smetana 2003). …”

Section: Discussionmentioning

confidence: 92%

Routine preoperative medical testing for cataract surgery

Keay

Lindsley

Tielsch

et al. 2012

Cochrane Database of Systematic Reviews

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Section: Discussionmentioning

confidence: 92%

Routine preoperative medical testing for cataract surgery

Keay

Lindsley

Tielsch

et al. 2012

Cochrane Database of Systematic Reviews

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“…The history should include a complete review of systems, medication history, surgical and anesthetic history, history of allergies and functional status. The physical examination and laboratory tests should be focused on information gathered from the history [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

“…Recent literature suggests that preoperative laboratory testing should be based on clinical examination rather than routine protocols [1][2][3][4][5][6]. Preoperative hemoglobin test or screening for anemia is included in most of the hospitals preoperative testing protocols in third world countries despite the fact that routine laboratory tests for all patients are not good screening device for diseases [3].…”

Section: Introductionmentioning

confidence: 99%

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Can Simple Preoperative Hemoglobin Testing Screen Symptomatic Anemia in Patients Undergoing Ambulatory Surgeries in Third World Countries?

Khan¹,

Khan²,

Samad³

2012

OJAnes

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Background: Patients coming for ambulatory surgeries are mostly healthy adults and asymptomatic anemia in these patients is rare. According to international standards, perioperative period is not an appropriate setting to screen and investigate the cause of asymptomatic anemia, but in third world countries where iron deficiency is rampant, it is generally required as per local hospitals policy to test hemoglobin levels prior to any surgery in order to prevent morbidity. The purpose of our study is to look at the prevalence of anemia in patient undergoing minor elective ambulatory surgeries. Method: This was a cross sectional observational study conducted at tertiary care unit, Karachi, Pakistan. A total of 385 ASA-I (American Society of Anesthesiologist) and II patient's age ranged 18 -60 years, scheduled for day care surgical procedures were enrolled in the study. Results: Anemia was detected in 74 (19.2%) patients and its prevalence was found to be higher in females and in patients above 50 years of age. However, the presence of anemia did not have any influence on the perioperative outcomes or management. Conclusion: The routine preoperative hemoglobin testing does not have any effect on the perioperative outcomes in asymptomatic patients who are planned for elective day care surgeries.

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“…Chest X-rays were performed if pathologic results occurred in physical examination or clinical signs such as dyspnea, orthopnea or tachypnea, fever or tachycardia were detected as well as if previous heart or pulmonary disease was known [19,20,21]. …”

Section: Methodsmentioning

confidence: 99%

Extra-Intracranial Standard Bypass in the Elderly: Perioperative Risk, Bypass Patency and Outcome

Sandow¹,

Weitzel-Mudersbach

Rosenbaum

et al. 2013

Cerebrovasc Dis

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Background: Patients with chronic atherosclerotic vessel occlusion and cerebrovascular hemodynamic insufficiency may benefit from extra-intracranial (EC-IC) bypass surgery. Due to demographic changes, an increasing number of elderly patients presents with cerebrovascular hemodynamic insufficiency. So far, little data for EC-IC bypass surgery in elderly patients suffering occlusive cerebrovascular disease are available. We therefore designed a retrospective study to address the question whether EC-IC bypass is a safe and efficient treatment in a patient cohort ≥70 years. Methods: 50 patients underwent EC-IC standard bypass surgery with translocation of the superficial temporal artery to an M2 segment of the medial cerebral artery. Criteria for bypass surgery were presence of symptomatic occlusive cerebrovascular disease of the anterior circulation and proof of a severely restricted or abrogated reserve capacity (detected by H₂O-photon emission tomography or single photon emission computer tomography - before and after forced vessel dilatation by diamox). The incidence of perioperative neurological and surgical complications, bypass patency, bypass function and short-term outcome were retrospectively analyzed. Results: The study cohort consisted of 16 patients ≥70 years (mean = 74.3 years, SE 1.3). It was compared to a cohort of 34 patients <70 years (mean = 61.2 years, SE 1.0). Both groups underwent EC-IC bypass surgery after careful preoperative work-up. Both patient groups did not differ significantly in gender, vascular pathology, previous history of diseases/comorbidity or clinical symptoms. The number of patients which underwent stenting or other endovascular treatments of the internal or common carotid artery prior to EC-IC bypass surgery was significantly higher in the group of patients ≥70 years (37.5 vs. 0%, p < 0.001). Perioperative stroke rate was 0% in both groups and mild morbidity occurred in 18.8 and 14.7%, respectively (p = 0.699). One 84-year-old female patient died due to perioperative endocarditis. Initial bypass patency was 93.8% in patients above the age of 70 years and 97.1% in the younger group (p = 0.542). Secondary occlusion rate was low in both groups (≥70 years: 0% vs. <70 years 3.7%). No new neurologic deficit occurred in patients with a patent bypass during the follow-up period (median 18 ± 13.1 months). Two patients with an initially occluded bypass and one with a secondary bypass occlusion suffered from new neurological symptoms. Conclusions: Our data show comparable safety and efficiency of EC-IC bypass surgery in patients under and above the age of 70 years due to a careful preoperative work-up and a strict indication for bypass surgery.

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Practice Advisory for Preanesthesia Evaluation

Cited by 302 publications

References 57 publications

Routine preoperative medical testing for cataract surgery

Routine preoperative medical testing for cataract surgery

Can Simple Preoperative Hemoglobin Testing Screen Symptomatic Anemia in Patients Undergoing Ambulatory Surgeries in Third World Countries?

Extra-Intracranial Standard Bypass in the Elderly: Perioperative Risk, Bypass Patency and Outcome

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