Do not perform routine blood tests on patients undergoing surgery (or anaesthetic evaluation).

Do not perform routine blood tests on patients undergoing surgery (or anaesthetic evaluation).

Type of practice

Laboratory tests

Age

Adult, Geriatric, Pediatric

Topic Area

Anesthesia, Analgesia, Resuscitation and Intensive Care

Routine and systematic execution of pre-operative laboratory tests is not recommended. The most recent international guidelines (NICE 2018 and ESA 2016), based on the current evidence, do not recommend their routine execution; if performed systematically they do not represent an added value for the stratification of clinical risk. The result is to postpone or cancel the surgical intervention in addition to significantly impacting costs and healthcare resources. It is recommended to plan pre-operative blood tests on the basis of the general clinical risk score resulting from the association of the patient’s risk (ASA Class), surgical invasiveness and anaesthetic technique.

Sources

1. De Hert S, Staender S, Fritsch G, Hinkelbein J, et al. Pre-operative evaluation of adults undergoing elective noncardiac surgery: Updated guideline from the European Society of Anaesthesiology. Eur J Anaesthesiol 2018 ;35:407-65.
2. National Guideline Centre (UK). Preoperative Tests (Update): Routine Preoperative Tests for Elective Surgery. London: National Institute for Health and Care Excellence (NICE); 2016.
3. Committee on Standards and Practice Parameters. Practice advisory for preanesthesia evaluation: an updated report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Anesthesiology 2012;116:522-38.
4. Klein AA, Arrowsmith JE. Should routine pre-operative testing be abandoned? Anaesthesia 2010; 65:974-6.
5. Società Italiana di Patologia Clinica e Medicina di Laboratorio. Non richiedere di routine esami di laboratorio preoperatori in pazienti a basso rischio (per chirurgia minore e per chirurgia intermedia nei pazienti ASA 1, ASA 2). https://choosingwiselyitaly.org/wp-content/uploads/2018/06/Scheda-SIPMeL-2017-2023-ok.pdf. [(ultimo accesso 14 febbraio 2024].

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Attention. Please note that these items are provided only for information and are not intended as a substitute for consultation with a clinician. Patients with any specific questions about the items on this list or their individual situation should consult their clinician.