Preoperative testing

Role of routine laboratory investigations in preoperative evaluation

“…There are still substantial areas of uncertainty in the literature due to the lack of randomized prospective trials and relatively low incidence of post-operative adverse events. [ 16 ] But the medical,[ 3 4 6 21 ] surgical,[ 6 18 35 44 ] and anesthesia[ 10 11 12 26 38 45 ] literature is replete with reports from studies that have established that screening tests without specific indication is wasteful. Based on the available data there is general consensus that only the selective tests should be advised consistent with the clinical evaluation[ 17 22 45 ] considering patients health status, presence of medical diseases, current medication, invasiveness or risk of proposed operative procedure (minimally, moderately or highly invasive),[ 14 ] and potential for blood loss.…”

“…[ 1 14 15 18 20 41 43 ] The tests should be obtained for specific clinical indication (e. g. obtain blood glucose in a known or suspected patient of diabetes or require complete blood count in surgeries where moderate or severe blood loss is expected) that may increase perioperative risk or influence management of anesthesia or surgery[ 10 14 15 41 43 46 ] and not simply because the patient is to undergo surgery. Healthy patients of ASA physical status I and II without co-existing medical condition undergoing minimally invasive outpatient surgery may require no routine investigations,[ 8 14 15 25 27 44 ] whereas those scheduled for moderately or severely invasive surgery which cause major physiological stress, few baseline tests may be done. [ 46 ] Further testing is needed only as per specific medical condition.…”