Are haematological tests warranted prior to tonsillectomy?

The use of phlebotomy for a full blood count (FBC) and group and serum storage (G&S) prior to tonsillectomy with or without adenoidectomy was assessed by means of a postal questionnaire sent to consultant otolaryngologists within the South West Thames region. This was compared with 'countrywide' practice assessed by means of questions to attenders at an otolaryngology course. A postal response rate of 86 per cent was obtained with 67 per cent within the region requesting a FBC prior to tonsillectomy and 50 per cent to adenoidectomy alone. This was much greater than for the 'countrywide' group with 24 per cent and 6 per cent respectively. Requests for pre-operative G&S were 17 per cent and 6 per cent respectively. This large difference in practice suggests that in the clinically healthy patient with no specific indications, pre-operative haematological investigations may be non-contributory, which has important financial implications. The maintenance of post-operative intravenous access is considered to be much safer, less traumatic and cheaper.