Exames complementares pré-operatórios: análise crítica

Mathias, L; Guaratini, Álvaro Antônio; Gozzani, Judymara Lauzi; Rivetti, Luiz Antonio

doi:10.1590/s0034-70942006000600011

Cited by 10 publications

(9 citation statements)

References 17 publications

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“…Furthermore, there is little evidence that any abnormalities found in tests compulsorily performed are associated with increased surgical morbidity. Evidence suggests that 60-70% of preoperative tests would be unnecessary if a careful clinical evaluation was performed [5][6][7][8][9][10][11][12][13][14] . However, routine preoperative tests increase hospital costs and provide no protection regarding legal medicine, becoming, in this sense, an eventual extra risk for medical staff when unnecessary tests result in requests for other diagnostic procedures, which may entail risks and complications for patients 4,10 .…”

Section: Discussionmentioning

confidence: 99%

“…Another aspect to consider is the reduction of hospital costs when tests are made wisely. During pre-anesthetic evaluation in most patients admitted for elective surgeries, complementary tests are routinely ordered 4 with the purpose of identifying or diagnosing diseases and disorders that may compromise the perioperative period, functional evaluation of previously diagnosed and under treatment diseases, and also help in the formulation of specifi c or alternative approaches for anesthetic care 5 . Routine tests are defi ned as compulsory tests for all patients regardless of the fi ndings obtained from clinical evaluation 4,6 .…”

Section: Introductionmentioning

confidence: 99%

“…It is estimated that of the US$30 billion spent in the U.S. on laboratory tests, at least 10% are intended for preoperative assessments. When taking into consideration the history and physical examination as determinants of preoperative tests, about 60-70% of laboratory tests would be unnecessary 5 . Vogt and Henson conducted a retrospective review of medical records and estimated hospital savings to be approximately US$80,000 annually just by eliminating preoperative testing not indicated for the 5,100 patients studied 2 .…”

Section: Introductionmentioning

confidence: 99%

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Relevância de exames de rotina em pacientes de baixo risco submetidos a cirurgias de pequeno e médio porte

Soares¹,

Brandão²,

Mourão³

et al. 2013

Rev. Bras. Anestesiol.

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Background and objectives: Preoperative tests aim to reduce morbidity and mortality of surgical patients, cost of perioperative care, and preoperative anxiety. Clinical evaluation allows defi ning the need for additional tests and strategies to reduce the surgical-anesthetic risk. The aim of this study was to evaluate the benefi t of routine preoperative testing of low-risk patients undergoing minor and medium surgical procedures. Methods: A descriptive cross-sectional study of 800 patients seen at the preanesthetic assessment department of Hospital Santo Antonio, Salvador, BA. Patients with physical status ASA I, aged 1-45 years and scheduled to undergo elective minor and medium surgeries were include in the study. We evaluated changes in blood count, coagulation profi le, electrocardiogram, chest X-ray, blood sugar, kidney function, sodium and potassium levels, and eventual change in clinical approach occurring due to these changes. Results: Of 800 patients evaluated, a blood count was performed in 97.5%, coagulation in 89%t, electrocardiogram in 74.1%, chest X-ray in 62%, fasting glucose in 68%, serum urea and creatinine in 55.7%, and plasma levels of sodium and potassium in 10.1%. Of these 700 patients, 68 (9.71%) showed changes in preoperative routine tests and only 10 (14.7%) of the patients with abnormal tests had a preoperative modifi ed approach (i.e., new tests ordered, referral to a specialist or surgery postponement). No surgery was suspended. Conclusion: We found that preoperative additional tests are excessively ordered, even for young patients with low surgical risk, with little or no interference in perioperative management. Laboratory tests, besides generating high and unnecessary costs, are not good standardized screening instruments for diseases.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Relevância de exames de rotina em pacientes de baixo risco submetidos a cirurgias de pequeno e médio porte

Soares¹,

Brandão²,

Mourão³

et al. 2013

Rev. Bras. Anestesiol.

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“…considering that the request of preoperative exams is aimed at identifying diseases or conditions that might compromise perioperative treatment 15,16 , its indication in healthy patients is controversial. narr et al 17 followed-up 1,044 healthy patients who underwent elective surgeries without preoperative ancillary exams and they did not observe perioperative morbidity or mortality.…”

Section: Discussionmentioning

confidence: 99%

Avaliação pré-anestésica e redução dos custos do preparo pré-operatório

Issa

Isoni

Soares

et al. 2011

Rev. Bras. Anestesiol.

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Summary: issa MRn, isoni nfc, Soares AM, fernandes Ml -Preanesthesia evaluation and Reduction of Preoperative care costs.Background and objectives: Preanesthesia evaluation (PAe) is fundamental in the preparation of a surgical patient. Among its advantages is the reduction of preoperative care costs. Although prior studies had observed this benefit, it is not clear whether it can be taken into consideration among us. the objective of the present study was to compare the costs of preoperative care performed by the surgeon with estimated costs based on PAe. in parallel, we compared the American Society of Anesthesiologists (ASA) physical status classification determined by the anesthesiologist with that estimated by other specialists.

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“…Todas as alterações referentes à hidratação, temperatura, coloração das mucosas e tempo de preenchimento capilar devem ser verificados para se evidenciar presença de anemia e anormalidades circulatórias (Shmon, 2007 Após o exame geral, deve-se proceder à avaliação da área afetada e dos órgãos adjacentes, embasando assim, a descrição do estado físico do animal e seu risco anestésico-cirúrgico (Fries, 2007). Quanto aos exames complementares no pré-operatório, os mesmos devem ser solicitados de modo seletivo, em função do exame físico minucioso, com o propósito básico de guiar e otimizar o cuidado perioperatório, levando em consideração as informações obtidas no prontuário do paciente, histórico clínico, exame físico, tipo e porte do procedimento cirúrgico (Mathias et al, 2006) Se o procedimento cirúrgico for de duração inferior a 60 minutos: VG, PT e urinálise. Se a cirurgia for realizada em tempo superior a 60 minutos e o paciente com mais de 7 anos de idade: os testes dependem das instalações disponíveis.…”

Section: Revisão De Literaturaunclassified

Estado físico e risco anestésico em cães e gatos: Revisão

Rodrigues

Quessada

Moraes

et al. 2017

Pubvet

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RESUMO.Grande valia é dada à anestesia desde a sua descoberta. Fato que revolucionou diversas áreas médicas, incluindo a Medicina Veterinária. Para que a anestesia possa ser conduzida de modo adequado e satisfatório, exige-se uma avaliação prévia do paciente a ser submetido à cirurgia, como revisão ao histórico clínico, exame físico, exames complementares e por fim, uma avaliação de risco e estado físico. Sendo importante para direcionar o paciente para um protocolo anestésico condizente ao seu estado de saúde, bem como predizer o prognóstico do mesmo. Esta classificação de risco e estado físico, adotada pela Sociedade Americana de Anestesiologistas (ASA) é aceita e utilizada mundialmente por médicos humanos e veterinários, e amplamente abordada em trabalhos científicos que envolvem a anestesiologia, justificando-se assim, a grande importância da mesma, sendo o objetivo de estudo desta revisão.Palavras chave: Anestesia, cirurgia, canino, felino Physical state and anesthetic risk in dogs and cats: Review ABSTRACT. Great value has been given to anesthesia since its discovery. A fact that has revolutionized several medical areas, including Veterinary Medicine. In order for anesthesia to be conducted adequately and satisfactorily, a prior evaluation of the patient to be submitted to surgery, such as a review of the clinical history, physical examination, complementary exams and, finally, a risk assessment and physical condition is required. It is important to direct the patient to an anesthetic protocol appropriate to their state of health, as well as to predict the prognosis of the same. This classification of risk and physical status, adopted by the American Society of Anesthesiologists (ASA), is accepted and used worldwide by human and veterinary doctors, and is widely discussed in scientific works involving anesthesiology, justifying its great importance, being the objective of this review.Keywords: Anesthesia, surgery, canine, feline Estado físico y riesgo anestésico en perros y gatos: Revisión RESUMEN. Gran validez se ha dado a la anestesia desde su descubrimiento. Hecho que revolucionó diversas áreas médicas, incluyendo la Medicina Veterinaria. Para que la anestesia pueda ser conducida de manera adecuada y satisfactoria, se requiere una evaluación previa del paciente a ser sometido a la cirugía, como revisión del historial clínico, examen físico, exámenes complementarios y por fin, una evaluación de riesgo y estado físico. Es importante para dirigir al paciente a un protocolo anestésico que concuerde

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Exames complementares pré-operatórios: análise crítica

Cited by 10 publications

References 17 publications

Relevância de exames de rotina em pacientes de baixo risco submetidos a cirurgias de pequeno e médio porte

Relevância de exames de rotina em pacientes de baixo risco submetidos a cirurgias de pequeno e médio porte

Avaliação pré-anestésica e redução dos custos do preparo pré-operatório

Estado físico e risco anestésico em cães e gatos: Revisão

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