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The Value of Routine Tests before Pediatric Eye Surgery: A 10-Year Experience at a Tertiary Care Hospital
Hideyo Horikawa1, Mitsuhiro Matsuo1, Mitsuaki Yamazaki2
1Department of Anesthesiology, Faculty of Medicine, University of Toyama, Toyama, Japan.
Insights
Routine preoperative tests are rarely beneficial for pediatric eye surgery patients. Systemic complications are uncommon, suggesting tests should be reserved for clinically indicated cases or high-risk procedures.
Area of Science:
- Ophthalmology
- Pediatric Anesthesiology
- Perioperative Medicine
Background:
- Routine preoperative testing is no longer standard for adult ophthalmic surgery.
- Limited data exist on the value of these tests in pediatric populations undergoing eye surgery.
Purpose of the Study:
- To evaluate the impact of routine preoperative tests on systemic perioperative complications in pediatric patients undergoing ophthalmic surgery.
- To determine the incidence of complications by hospital discharge or 30 days post-surgery.
Main Methods:
- A single-center, observational, descriptive study analyzed 708 pediatric patients (≤17 years) undergoing eye surgery under general anesthesia.
- Data were collected from January 2010 to December 2019, focusing on anesthetic consultations and perioperative outcomes.
Main Results:
- The incidence of systemic perioperative complications was 0%.
- Only 2.1% of patients had surgery postponed due to physical exam findings; 0.3% required further evaluation for lab abnormalities, which were ultimately unremarkable.
- Most patients (97.6%) proceeded with surgery as scheduled.
Conclusions:
- Systemic perioperative complications are rare following pediatric ophthalmic surgery.
- Routine preoperative tests should be reserved for cases with clinical indications or for procedures with high bleeding risk, such as those involving malignancy or trauma.
Background:
Routine tests before ophthalmologic surgery in adult patients are no longer recommended. However, there are limited data on the utility of routine preoperative tests for children.
Aims:
We aimed to describe the effect of routine preoperative tests on systemic perioperative complications by hospital discharge or by day 30 following eye surgery.
Settings And Design:
This was a single-center, observational, and descriptive study.
Subjects And Methods:
We examined all patients ≤ 17 years old for whom ophthalmologists consulted with anesthesiologists before eye surgery under general anesthesia in an academic teaching tertiary care hospital from January 2010 to December 2019.
Results:
A total of 708 pediatric patients were analyzed. The mean patient age was 8.5 ± 4.6 years. The most frequently performed procedure was strabismus surgery in 433 patients (61.2%). Following anesthetic consultations, 15 patients (2.1%) underwent surgery postponed due to abnormalities at the physical examination. Routine tests identified that the two patients (0.3%) required additional evaluations due to elevated serum creatine kinase and electrocardiographic abnormalities. However, further examinations found that these abnormalities were unremarkable. The remaining 691 patients (97.6%) underwent surgery as scheduled. Substantial intraoperative blood loss was observed only in three patients with malignant tumors or trauma. The incidence of systemic complications was 0 (0%; 95% confidence interval, 0%-0.05%).
Conclusions:
These data indicated that the development of systemic perioperative complications following pediatric ophthalmic surgery is rare. Preoperative tests should be requested only if they are clinically indicated or before potentially bleeding procedures, such as malignancy or trauma surgery.
