Preoperative Testing

Before Non-cardiac Surgery: Guidelines and Recommendations

Cataract Surgery No pre-operative testing is indicated. Individual patient history driven.
Chest X-Ray There is no high-quality evidence on the effectiveness of routine pre-operative chest radiography.
Coagulation Testing Patients taking anticoagulants, and those whose history or examination findings suggest an underlying coagulation disorder (e.g., history of spontaneous bruising or excessive surgical bleeding, family history of a known heritable coagulopathy). Bleeding history should be obstained from all sugical patients, and appropriate coagulation testing should be considered if the history is abnormal. Complete Blood Count Recommend testing for select patients based on conditions that would increase the pretest probability of diagnosing anemia (e.g., a chronic liver disease, clinical signs or symptoms of anemia) or procedures in which significant blood loss in anticipated.
Urinalysis Routine urinalysis is not recommended in asymptomatic patients except in those undergoing surgical implantation of foreign material (e.g., prosthetic joint, heart valve) or invasive urologic procedures.
Electrocardiogram  Diagram of electrocardiogram
Electrolyte/Creatinine Routine testing is not indicated but should be considered when compelling historical findings (e.g., hypertension, heart failure, chronic kidney disease, complicated diabetes mellitus, liver disease) and certain medications (e.g., diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, nonsteroidal anti-inflammatory drugs, digoxin) should drive the decision to perform preoperative electrolyte and creatinine testing.
Glucose/HgbA1c The guidelines suggest that preoperative random glucose measurement could be considered in patients at very high risk of undiagnosed diabetes on the basis of history, examination, or use of certain medications (e.g., glucocorticoids), and in patients with signs or symptoms of undiagnosed diabetes.

 

Reference Sources

Institute for Clinical Systems Improvement, https://www.icsi.org/guideline/perioperative-guideline 04/2021
American Academy of Family Physicians, https://www.aafp.org/afp/2013/0315/p414.html#afp20130315p414-t1 04/2021

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