The necessity of preoperative labs has changed over the years as we have learned more about what they actually tell us about your health. What we have learned is that a good history and physical exam can tell you whether or not any lab tests are necessary. For those under 60 without symptoms or findings of any disease and a normal blood pressure, the only suggested lab test our anesthesiologists suggest are a hematocrit in women with heavy menses and a pregnancy test if there is a chance of pregnancy, again, based on history.
Thank you for your question. I understand why you are concerned but please be assured that for healthy patients routine laboratory tests aren't required. I agree with Dr. DeMars below and disagree with the other two respondents. My practice situation sound similar to his. Our anesthesiologists do not ask for laboratory work on healthy patients under age 60. Complete patient history and physical examination done before surgery is far more important than laboratory studies.
However the one test we feel is very important is a pregnancy test for women of child bearing age. We do this in our office on the morning of surgery. Drugs used for sedation and general surgery could adversely affect the fetus.
I have been doing surgery for over 35 years under general anesthesia first as a general surgeon and later as a plastic surgeon. The standard of care definitely does not include routine labs on a healthy patient. This has been a change over the years as one published study after another has shown routine labs done without proper indication to be a waste of money and resources. I work routinely with 6-8 different anesthesiologists and none of them require routine labs on anyone under 60.
You should be concerned, all surgical procedure under general anesthesia require pre-op labs.I have my patients do a basic blood work there could be anything wrong and not know it. If you want to feel more comfortable got to your primary doctor having him/her order a pre-op lab order.
Practices will vary. In our practice, pre-op blood work depends on your age and health status (medical history). At the very least, a hemoglobin and pregnancy test is useful for most of our patients. For older patients (or those with specific medical problems where extensive blood /EKG workup is indicated) a medical clearance from a primary care doctor or specialist (depending on patient medical history) may be necessary.
Interesting the number of different responses! Lab work in my area is guided by preoperative risk factors. For young, healthy women, the only necessary labs are a hemoglobin (to make sure you are not anemic due to menstrual cycles) and a pregnancy test. These basic labs are checked the day of your surgery. I have only had to cancel surgery once due to a positive pregnancy test. No one has ever been anemic. Hope this helps.
Well I think all patients demand a blood count, basic chemistry and pregnancy test (if applicable). Every surgeon and facility is different in what is required but what I listed is the standard of care.
Earl Stephenson, Jr, MD, DDS, FACS
Even you are young and healthy--and do not require a medical clearance--- before each surgical procedure performed under general anesthesia-- it is a requirement to get blood work, EKG and in some cases- chest x-ray done prior to the surgery. Safety of the patient is essential!
There is nothing more important than safety in order to prevent risk of complications during and after surgery.
Lab work and EKG will let us know and confirm you are healthy and can have surgery safely.
I personally would never perform on a patient without lab work.
Pre-op labs are not always necessary even if you are going under general anesthesia. If you are in a good state of health and have no significant past or current medical problems, most tests are unnecessary. There is plenty of data in the anesthesia and general surgery literature that supports the fact that too many tests are ordered. Again, this is very dependent on your medical history. If you trust your surgeon, you should feel comfortable with his/her decision. If you have any questions, talk to him/her. Good luck with your upcoming surgery!