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Preoperative Testing

A complete history and physical examination should first be performed to uncover signs of preexisting disease and identify patients who are potentially at high risk for specific disorders. Individual laboratory tests can then be ordered to verify the existence of the suspected condition and to optimize treatment. The following table summarizes preoperative testing strategies that have evolved from expert review of the literature (JAMA 1994; 271: 319-20 & Arch Pathol Lab Med 1995; 119: 518-22).

Condition

CBC

Coag

Lytes

Creat

Glu

AST

hCG

T&S

Procedure w/ blood loss

X

X

Procedure w/o blood loss

Age >60 y

X

CV disease

X

Pulmonary disease

X

Cancer

X

Leukemia

X

X

Radiation Rx

X

Hepatic disease

X

X

X

Hepatitis exposure

X

Renal disease

X

X

X

Bleeding Disorder

X

X

Diabetes

X

X

X

Smoking

X

Possible pregnancy

X

Diuretic

X

X

Digoxin

X

X

Steroids

X

X

Anticoagulant

X

X

CNS disease

X

X

X

X

Coag = PT, PTT, fibrinogen; Creat = serum creatinine; Gluc = plasma glucose; hCG = urine pregnancy test; T&S = type and screen.

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