Preoperative Investigations in ASA I and II Patients – Do We Really Follow Recommendations?

Background: Pre-anaesthetic check up (PAC) is to assess the clinical condition of patient and advice necessary investigations. This ultimately helps in risk stratification of patients. Though there are recommendations for evaluating patients, it is not getting followed and investigative modalities are increasing and clinical touch is lacking. We aimed to show that the preoperative investigations needed to optimize patients for surgery are exceeding the recommendations. Methods: We carried a prospective, observational study in 200 ASA I and II patients, of either sex or any age group. The record of the investigations was done which was already advised and any advice further given by senior anaesthesiologist. Results: Though ASA I and II patients do not need most of the investigations, CBP, SE, RFT, coagulation profile, ECG and CXR were advised already by surgeons, in almost 100 % patients. TFT was already done in 15 (25%) patients of ASA II group posted for thyroid surgery, only in 5 (8.3%) patients it was needed to demand. ECHO also same way was already done in 63 (45%) patients of ASA I group and 46(76.7%) patients of ASA II group. Out of cardiology referrals, 14 (10%) was done by surgeons themselves and clearance for surgery was taken though belong to ASA class I.