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Abstract：
Introduction Laboratory testing is done before surgery to identify body abnormalities that cannot be detected through clinical evaluation alone. Patients going in for low- or intermediate-risk surgeries are often encouraged to undergo a battery of tests as usual. This cross-sectional observational study evaluated the status of routine pre-operative laboratory tests in American Society of Anaesthesiologists (ASA) Grade I, II, and III adults undergoing elective surgery at a maternity hospital, as well as the impact of these tests on the outcome of the pre-anaesthetic check-up (PAC). Methods The present observational study was conducted on 500 patients scheduled for elective surgery under anaesthesia. The procedures included routine gynaecological and obstetric surgeries like abdominal hysterectomy, suction evacuation, laparotomy for ectopic pregnancy, diagnostic biopsy, and lower segment caesarean section, among others. A designated anaesthesiologist gathered information from the completed PAC sheets. As per the standard departmental policy, each patient underwent a clinical examination and routine investigations at the PAC clinic. In addition to demographic and other variables, laboratory test results and any peri-operative interventions performed due to abnormalities were assessed. Investigations already done, asked by anaesthesiologists, and referral services sought were noted. The impact of these investigations on anaesthetic decision-making was noted. Data were expressed in frequencies and percentages and statistically analysed using INSTAT software (GraphPad Prism Software Inc., La Zolla, USA). Results The age and weight of the patients range from 20 to 70 years and 55 to 95 kg. Most patients belonged to ASA Grade II (n=348, 69.6%). Hypothyroidism was the most common abnormal finding (n=122, 22.4%). Anaemia, hypertension, and diabetes were detected in n=8 (1.6%), n=82 (16.4%), and n=34 (6.8%) of patients, respectively. In 488 (97.6%) patients, one or more of the investigations from the list were pending. Based on the results of various preoperative laboratory investigations, 87 (17.4%) patients were advised of multiple specialty opinions before surgery. A total of 453 (90.6%) patients attending the clinic were recommended to review their PACs after their pending investigations and specialist consultations were completed. At the same time, n=41 (8.2%) was found to be fit for surgery, and n=6 (1.2%) was found unfit for surgery and was postponed. Conclusions The incidence of tests with abnormal results was a little high in our study. One reason could be that a particular group of patients is included in the study. Preoperative laboratory investigations substantially increase the costs. Not many patients with abnormal tests may require changes in their peri-anaesthetic management. Nonetheless, laboratory tests can help ensure the patient is in an ideal preoperative condition. Pre-operative laboratory investigations should be advised on a case-by-case basis to avoid inconveniencing the patient, delaying the surgical procedure, and driving up the cost of surgical treatment.
摘要：
引言实验室检测是在手术前进行的，以确定不能通过临床评估单独检测的身体异常。通常鼓励进行低风险或中等风险手术的患者像往常一样接受一系列测试。这项横断面观察性研究评估了美国麻醉医师协会（ASA）I级常规术前实验室检查的状态，II,和在妇产医院接受择期手术的III名成年人，以及这些测试对麻醉前检查（PAC）结果的影响。方法对500例择期手术患者进行观察性研究。这些程序包括常规的妇科和产科手术，如腹部子宫切除术，抽真空,剖腹手术治疗异位妊娠,诊断活检,下段剖腹产，在其他人中。指定的麻醉师从完成的PAC表中收集信息。根据标准部门政策，每例患者均在PAC诊所接受临床检查和常规检查.除了人口统计和其他变量，我们对实验室检查结果和因异常而进行的任何围手术期干预进行了评估.调查已经完成,麻醉师问，并注意到所寻求的转介服务。注意到这些调查对麻醉决策的影响。数据以频率和百分比表示，并使用INSTAT软件（GraphPadPrismSoftwareInc.，LaZolla,美国）。结果患者的年龄和体重范围为20至70岁，55至95kg。大多数患者属于ASAII级（n=348，69.6％）。甲状腺功能减退是最常见的异常发现（n=122，22.4%）。贫血,高血压,在n=8（1.6％）中检测到糖尿病，n=82（16.4%），n=34（6.8％）的患者，分别。在488名（97.6%）患者中，名单上的一项或多项调查正在等待中。根据各种术前实验室检查的结果，87例（17.4%）患者在手术前被告知多种专业意见。共有453名（90.6％）在诊所就诊的患者被建议在等待的调查和专家咨询完成后复查他们的PAC。同时,n=41（8.2％）被发现适合手术，n=6（1.2％）被发现不适合手术并被推迟。结论在我们的研究中，测试结果异常的发生率较高。一个原因可能是研究中包括了一组特定的患者。术前实验室检查大大增加了成本。没有多少异常检查的患者可能需要改变其周围麻醉管理。尽管如此，实验室检查可以帮助确保患者处于理想的术前状态。术前实验室检查应根据具体情况建议,以免给患者带来不便,推迟外科手术,并抬高了手术治疗的费用。
