Key result
Abnormal preoperative laboratory tests ordered by surgeons did not influence anaesthetic management in 70.5% of cases, but led to delay, cancellation, or blood transfusion in 29.5% of cases.
Why the study?
Preoperative laboratory investigations are routinely ordered by surgeons without clinical indications on speculation that anaesthetists require them, but their actual impact on perioperative anaesthetic decisions remains unclear.
Do preoperative laboratory tests ordered by surgeons influence the anaesthetic management of patients undergoing elective surgery?
Cross-Sectional (n=165)
No
Do preoperative laboratory tests ordered by surgeons influence the anaesthetic management of patients undergoing elective surgery?
Preoperative laboratory tests ordered by surgeons often do not significantly influence anaesthetic management, suggesting potential overuse of routine testing.
Answers are grounded in this paper and cite their sources.
Preoperative labs rarely alter anaesthetic plans but may cause delays; leaves open whether selective testing improves efficiency in surgical patients.
Background: Request for preoperative laboratory investigations is usually done by surgeons. On some occasions, the patient may come with laboratory investigations that have been requested by the primary physician. This occurs in situations where the primary physician saw the patient first and referred to the surgeon. There is usually no indications based on history or physical examination before these laboratory request is done but rather on speculations that the “anaesthetist may require them”. This is done in order to avoid cancellation or delay of cases. The aim of this study was to find out how tests ordered in Komfo Anokye Teaching Hospital (K.A.T.H.) by the surgeons affected the decisions of the anaesthetists in the perioperative management of the patients. Methodology: This was a prospective, cross sectional study of patients undergoing elective surgery at K.A.T.H from 1st to 31st March 2014. A quantitative technique was used to effectively quantify laboratory results that were contained in a patient’s folder before an elective surgical procedure. A close and open-ended questionnaire was developed and answered by reviewing patient’s folders during the pre-anesthesia assessment. Data were analyzed using Statistical Package of Social Sciences (SSPS) version 22. Results: The average age of patients studied was 50 years. Abnormal test results did not influence the anaesthetic management in 70.5% of cases but led to either delay or cancelation of cases or requirement for transfusion of blood or blood products in 29.5% of cases. Conclusion: Preoperative laboratory tests ordered by Surgeons in KomfoAnokye Teaching Hospital do not significantly influence the anaesthetic managements of patients.
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Antwi‐Kusi et al. (2019) conducted a cross-sectional in Elective surgery (n=165). Preoperative laboratory testing ordered by surgeons was evaluated on Influence of abnormal test results on anaesthetic management (delay, cancellation, or blood transfusion). Abnormal preoperative laboratory tests ordered by surgeons did not influence anaesthetic management in 70.5% of cases, but led to delay, cancellation, or blood transfusion in 29.5% of cases.
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