[Current practice and attitude of anesthesiologists for prescribing preoperative investigative tests]

A telephone enquiry was undertaken to assess current practice among French anaesthetists, and to obtain their opinion, concerning preoperative laboratory screening tests. It included 204 anaesthetists, randomly selected from the membership directory of the French Society of Anaesthetics and Intensive Care. The sample was concordant with the distribution (sex and age) given by the specialists' list of the National Medical Council. It comprised 64.2% male anaesthetists, and the overall mean age was 44.2 years. On average, each anaesthetist carried out 26 elective and 4 emergency anaesthetist a week. An organized preanaesthetic consultation was available in only 73% of public hospitals. However, even when existing, it does not automatically concern all surgical stations of the hospital and only 59% of patients benefit from that consultation. In 55% of patients the screening tests had still been made before the preanaesthetic consultation for scheduled surgery. About 15% of patients were seen for the first time by an anaesthetist on the very day of surgery. A routine prescription of preoperative tests was not systematic. Non prescription ranged from 7 to 34% of patients, depending on the tests. The responders recognized that for the same tests the rate could be comprised between 21 and 66% of patients. Moreover, 38% of anaesthetists admitted that sometimes they did not see results of the prescribed tests before carrying out the anaesthetic. Overprescription of preoperative tests has been recognized. However, legal, organisational, relational or economical reasons are given which may explain difficulties met with to rationalize prescription of these tests.