[Which preoperative tests in ambulatory surgery?]

Anaesthesia for ambulatory surgery implies a strict selection of patients. Screening tests are non specific, compared to these ordered for in-patients. However, detailed preoperative evaluation is mandatory for ambulatory care to function correctly. Many studies conclude that 60% of routine screening tests are of no value: no proven benefit in either anaesthetic management or in the detection of pathologies which might interfere with anaesthesia has been shown with systematic preoperative examinations in asymptomatic subjects (adults or children). The detection of an asymptomatic anomaly by routine testing is extremely infrequent and does not lead to changes in the operating schedule or in the outcome of anaesthesia. Clinical examination and patient history are the only predictive elements, so systematic complementary tests should be abandoned and replaced by judicious selective prescription.