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Preoperative laboratory testing in children undergoing elective surgery: analysis of current practice
R I Patel1, L DeWitt, R S Hannallah
1Department of Anesthesiology, Children's National Medical Center, Washington, D.C. 20010, USA.
Journal of Clinical Anesthesia
|November 5, 1997
Summary
Many physicians still order routine preoperative lab tests for healthy children undergoing elective surgery, despite evidence showing no specific benefits. This practice continues despite studies indicating a lack of necessity for these tests in pediatric patients.
Area of Science:
- Pediatric Anesthesiology
- Preoperative Medicine
- Clinical Practice Guidelines
Background:
- Routine preoperative laboratory testing in healthy children undergoing elective surgery is common practice.
- Evidence suggests that many of these tests lack specific benefits for this patient population.
Purpose of the Study:
- To evaluate the current practices of preoperative testing for healthy children undergoing elective surgery.
- To understand the rationale behind routine testing in pediatric patients.
Main Methods:
- A survey was distributed to members of the Society for Pediatric Anesthesia across North America.
- 1,200 questionnaires were mailed, inquiring about routine tests like complete blood count (CBC), hemoglobin (Hb), hematocrit (Hct), urine analysis (UA), pregnancy tests, hemostatic tests (PT, PTT), and sickle cell testing.
Main Results:
- A 57% response rate (685/1,200) was achieved.
- Hemoglobin testing was routine in 27-48% of children. Urine analysis was ordered in <15%. Pregnancy tests were ordered by 43%, and hemostatic tests before tonsillectomy by 45% of respondents.
Conclusions:
- Current practices indicate widespread routine preoperative laboratory testing for healthy children undergoing elective outpatient surgery.
- Physicians continue to order tests despite studies showing no specific benefits, highlighting a gap between evidence and practice.