Ambulatory Surgery: How Much Testing Do We Need?

The pre-anesthetic evaluation for ophthalmic surgery in the elderly is really necessary? The reality of a public hospital

“…The data also indicated that the pre-anesthetic evaluation revealed new diagnostic possibilities and changed clinical and laboratory conditions, as hypertension 17 and diabetes mellitus 18 . Ophthalmologic surgeries are the most common surgeries in elderly patients, especially correction of cataract [19][20][21][22][23][24][25] . A lot of them are outpatients, with the use of local anesthesia, usually in conjunction with intravenous sedation.…”

Criteria for the request of preoperative tests among oral and maxillofacial surgeons

“…While routine preoperative tests contribute toward raising healthcare costs, the benefit of such tests in terms of patient care is debatable (Roizen, 1989;OSTEBA, 1994;Pasternak, 2004;Mathias et al, 2006;Richman, 2010). Roizen (1989) states that a greater number of tests requested increases the possibility of a normal patient having an altered exam due to the mean and standard deviation values.…”

“…Nonetheless, the routine requesting of standardized sets of tests has been questioned (Mathias et al, 2006;Richman, 2010). In the past, the supposition was that all elective surgery should be preceded by a global set of tests, regardless of the patient's age, health status or scheduled procedure (Roizen, 1989;OSTEBA, 1994;Pasternak, 2004).…”

Recomendaciones de pruebas preoperatorias en el paciente adulto para procedimientos en régimen de cirugía ambulatoria

“…En el contexto de la cirugía sin ingreso, recientes evidencias sugieren que los pacientes de cualquier edad y sin comorbilidad importante, estado físico ASA I y II, no necesitan pruebas preoperatorias complementarias de forma rutinaria 21,24 .…”

“…Algunos autores estiman un coste muy elevado si se realiza esta prueba a todas las mujeres en edad fértil 101,102 . No está claro en qué medida la anestesia afecta al feto, pero las recomendaciones actuales son las de no realizar una cirugía programada en pacientes embarazadas, especialmente en el primer trimestre 24 . El NICE no llegó a un consenso para la realización universal de una prueba de embarazo en todas las pacientes en edad reproductiva.…”