Preoperative Evaluation of Patients Undergoing Non-cardiac Surgery

Traditionally, routine tests have been considered important elements of preanesthetic evaluationPreanesthetic evaluation to determine fitness for surgery. Over the past four decades, this practice has been scrutinized due to a low yield and high cost. In fact, routine tests such as complete blood count (CBC), chest X-ray, electrocardiogram (EKG), urinalysis, and electrolyte panel are of little value in detecting disease or changing management. Rather multiple investigations detect minor irrelevant abnormalities, increase patient risk, cause delay, and increase liability. Many reviews and studies have confirmed these findings that routine testing does little or nothing to aid in effective preanesthetic assessment. Rather, postoperative complicationsPostoperative complications were linked to higher ASA classification, longer duration of anesthesia, more complex surgery, and poor nutritional status. More importantly recent studies indicate that risk assessment for cognitive dysfunction and prediction of other complications are important.