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.

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

References

Roizen MR, Cost-effective preoperative laboratory testing, J Amer Med Assoc,1994;271: 319-20.

Nardella, et al, Continuous improvement, quality control, and cost containment in clinical laboratory testing. Effects of establishing and implementing guidelines for preoperative tests, Arch Pathol Lab Med 1995;119:518-22.

Bock M, et al, Preoperative Laboratory Testing, Anesthesiology Clin, 2016;34:43-58.

Martin SK, Cifu AS, Routine preoperative laboratory tests for elective surgery, J Amer Med Assoc, 2017;318(6):567-568.

Kirkham KR, et al, Preoperative Laboratory Investigations: Rates and Variability Prior to Low-Risk Surgical Procedures, Anesthesiology, 2016;124(4):804-814.

Society of General Internal Medicine. Don’t perform routine pre-operative testing before low-risk surgical procedures. Choosing Wisely. An initiative of the ABIM Foundation. September 12, 2013. www.choosingwisely.org/clinician-lists/society-general-internal-medicine-routine-preoperative-testing-before-low-risk-surgery/. Accessed August 31, 2015.

Rohrer MJ, Michelotti MC, Nahrwold DL. A prospective evaluation of the efficacy of preoperative coagulation testing. Ann Surg 1988; 208:554–557.

Schein OD, Katz J, Bass EB, et al. The value of routine preoperative medical testing before cataract surgery. Study of Medical Testing for Cataract Surgery. N Engl J Med 2000; 342:168–175.