Preoperative laboratory testing in children undergoing elective surgery: analysis of current practice.
OBJECTIVE
To evaluate current practice in preoperative testing of healthy children undergoing elective surgery that is not expected to result in significant blood loss.


METHODS
Survey of members of the Society for Pediatric Anesthesia.


METHODS
Anesthesiologists practicing in North America.


METHODS
A total of 1,200 questionnaires were mailed.


METHODS
Questionnaires were mailed to all members of the Society for Pediatric Anesthesia. All members were asked to specify which tests were routinely performed and to state why. Specific questions were asked about performing complete blood count (CBC), hemoglobin (Hb), hematocrit (Hct), and urine analysis (UA) in all patients, pregnancy test in adolescents, prothrombin time (PT) and activated partial thrombin time (PTT) prior to tonsillectomy, and sickle cell testing in black and/or Mediterranean children.


RESULTS
685 of 1,200 (57%) questionnaires were returned. No attempt was made to identify and follow-up with nonresponders. Hb testing is routinely performed in 27% to 48% of the children depending on the age of the patient. UA is ordered preoperatively in less than 15% of the children. Pregnancy test was ordered by 43% of the respondents. Hemostatic tests prior to tonsillectomy were conducted by 45% of the anesthesiologists.


CONCLUSIONS
The results indicate the present practice of routine preoperative laboratory testing for children undergoing elective outpatient surgery. In spite of the many studies that indicate no specific benefits of performing routine preoperative testing in healthy children undergoing scheduled surgery, many physicians continue to order these tests in all such children.
Patel
R I
RI
Department of Anesthesiology, Children's National Medical Center, Washington, D.C. 20010, USA.
DeWitt
L
L
Hannallah
R S
RS
D000755:Anemia, Sickle Cell / Q000175:diagnosis; D000758:Anesthesia; D001772:Blood Cell Count; D001780:Blood Coagulation Tests; D002648:Child; D002675:Child, Preschool; D019411:Clinical Laboratory Techniques; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010818:Practice Patterns, Physicians' / Q000592:standards; D011247:Pregnancy; D011258:Pregnancy Tests; D011300:Preoperative Care; D013902:Radiography, Thoracic; D011795:Surveys and Questionnaires; D014068:Tonsillectomy; D016482:Urinalysis