PREOPERATIVE LABORATORY TESTING IN CHILDREN UNDERGOING ELECTIVE SURGERY - ANALYSIS OF CURRENT PRACTICE

Study Objective: To evaluate current practice in preoperative testing of healthy children undergoing elective surgery that is not expected t o result in significant blood loss. Design: Survey of members of the S ociety for Pediatric Anesthesia. Setting: Anesthesiologists practicing in North America. Population: A total of 1,200 questionnaires were ma iled. Interventions: Questionnaires were mailed to all members of the Society for Pediatric Anesthesia. All members were asked to specify wh ich tests were routinely performed and to state why. Specific question s were asked about performing complete blood count (CBC), hemoglobin ( Hb), hematocrit (Hct), and urine analysis (UA) in all patients, pregna ncy test in adolescents, prothrombin time (PT) and activated partial t hrombin time (PTT) prior to tonsillectomy, and sickle cell testing in black and/or Mediterranean children. Measurements and Main Results: 68 5 of 1,200 (57%) questionnaires were returned. No attempt was made to identify and follow-up with nonresponders. Hb testing is routinely per formed in 27% to 48% of the children depending on the age of the patie nt. UA is ordered preoperatively in less than 15% of the children. Pre gnancy test was ordered by 43% of the respondents. Hemostatic tests pr ior to tonsillectomy were conducted by 45% of the anesthesiologists. C onclusion: The results indicate the present practice of routine preope rative laboratory testing for children undergoing elective outpatient surgery. In spite of the many studies that indicate no specific benefi ts of performing routine peroperative testing in healthy children unde rgoing scheduled surgery, many physicians continue to order these test s in all such children. (C) 1997 by Elsevier Science Inc.