Conducting baseline laboratory investigations before low-risk non-cardiac surgery contributes little value to perioperative care. A focused clinical history and physical examination may reliably identify relevant abnormalities sought by routine laboratory testing before low-risk surgery. In addition, evidence suggests that abnormal results in this setting only rarely influence management and do not improve clinical outcomes. Preoperative testing may add value in the setting of a symptomatic patient or higher-risk surgery, but should not be performed routinely before low-risk surgery on asymptomatic patients.
Sources:
Committee on Standards and Practice Parameters, et al. Practice advisory for preanesthesia evaluation: an updated report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Anesthesiology. 2012 Mar;116(3):522-38. PMID: 22273990.
Czoski-Murray C, et al. What is the value of routinely testing full blood count, electrolytes and urea, and pulmonary function tests before elective surgery in patients with no apparent clinical indication and in subgroups of patients with common comorbidities: a systematic review of the clinical and cost-effective literature. Health Technol Assess. 2012 Dec;16(50):i-xvi, 1-159. PMID: 23302507.
Keay L, et al. Routine preoperative medical testing for cataract surgery. Cochrane Database Syst Rev. 2012 Mar 14;3:CD007293. PMID: 22419323.
Merchant R, et al. Guidelines to the practice of anesthesia–revised edition 2015. Can J Anaesth. 2015 Jan;62(1):54-67. PMID: 25323121.
Related Resources:
Patient Pamphlet: Lab Tests Before Surgery: When you need them and when you don’t
Toolkit: Drop the Pre-Op – A toolkit for reducing unnecessary visits and investigations in pre-operative clinics