Routine Investigations Prior To Surgery

The ordering of laboratory tests is still largely empirical with marked differences between hospitals and individuals. Evidence-based consensus guidelines have been developed to assist decision making (National Institute for Clinical Excellence - NICE http://www.nice.org.uk/pdf/cg3niceguide-linea4.pdf. Broad issues to consider in applying these guidelines are:

• complexity of intended surgery,

• ASA classification,

• nature of co-morbidity present (ASA 2). Some brief suggestions are listed in Table 1.12.

Biochemistry

Significant previously undetected abnormalities occur in <1% of cases, but occult diabetes and renal impairment are

Table 1.12. Routine preoperative tests for asymptomatic patients.

Chest radiograph

TB suspected

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