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[Ambulatory anesthesia: which preoperative screening tests are required].
S Hesse1, A Seebauer, D Schwender
1Institut für Anaesthesiologie, Ludwig-Maximilians-Universität, Klinikum Grosshadern, München.
Der Anaesthesist
|March 27, 1999
Summary
Routine preoperative screening investigations often yield no clinically relevant findings and rarely impact patient care. A selective approach, prioritizing medical history and physical exams, is more cost-effective and efficient for assessing anesthesia and surgical risk.
Area of Science:
- Anesthesiology
- Medical Diagnostics
- Health Economics
Context:
- Preoperative assessment practices vary widely, from selective testing to extensive routine investigations.
- Current programs warrant reevaluation for benefit and efficacy.
- The increasing volume of preoperative testing contributes significantly to healthcare costs.
Purpose:
- To reassess the value and effectiveness of routine preoperative assessment programs.
- To determine the clinical relevance of preoperative screening investigations.
- To identify cost-effective strategies for preoperative patient evaluation.
Summary:
- Numerous studies indicate that preoperative screening investigations seldom reveal new, clinically significant pathological findings.
- Abnormal laboratory results in healthy patients typically do not alter anesthetic management or correlate with perioperative complications.
- A thorough clinical history and physical examination are effective screening tools, often obviating the need for extensive diagnostic procedures.
Impact:
- Implementing a selective approach to preoperative investigations can lead to substantial cost savings in healthcare.
- Efficient organization of preoperative assessment is crucial to prevent delays and cancellations.
- Focusing on clinical evaluation reduces unnecessary diagnostic procedures, improving cost-effectiveness.