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Impact of using a local protocol in preoperative testing: blind randomized clinical trial
Mônica Loureiro Santos1, Antônio Carlos Iglesias1,2
1- Gaffree and Guinle University Hospital, Federal University of the State of Rio de Janeiro, Service of Anesthesiology, Rio de Janeiro, Rio de Janeiro State, Brazil.
A new protocol for preoperative test requests significantly reduced unnecessary exams by 57.3% without increasing surgical complications. This approach streamlines testing, benefiting patient care and healthcare efficiency.
Area of Science:
- Anesthesiology
- Surgical Management
- Healthcare Optimization
Background:
- Preoperative testing is a routine part of surgical care.
- The necessity and impact of routine preoperative exams are debated.
- Over-requesting tests can lead to increased costs and potential patient harm.
Purpose of the Study:
- To assess a local protocol's effectiveness in reducing preoperative test requests.
- To evaluate the protocol's impact on surgical anesthetic management.
- To determine the protocol's effect on perioperative complications.
Main Methods:
- A randomized, blinded clinical trial involving 405 patients undergoing elective surgery.
- Two groups: non-selective exam requests versus protocol-guided requests.
- Key exams studied included complete blood count, coagulogram, and others.
Main Results:
- A 57.3% reduction in requested exams was observed with the protocol (p<0.001).
- Fewer abnormal test results occurred in the protocol group (14.9% vs. 29.1%).
- No significant difference in changes to anesthetic management or complications was found.
Conclusions:
- The protocol effectively reduced unnecessary preoperative tests.
- Implementation did not increase perioperative morbidity or mortality.
- Selective preoperative testing can be safely integrated into surgical practice.
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