Preoperative Laboratory Testing by Surgeons: Implication on Anaesthetic Management

Abstract

Background: Request for preoperative laboratory investigations is usually done by surgeons. On some occasions, the patient may come with laboratory investigations that have been requested by the primary physician. This occurs in situations where the primary physician saw the patient first and referred to the surgeon. There is usually no indications based on history or physical examination before these laboratory request is done but rather on speculations that the “anaesthetist may require them”. This is done in order to avoid cancellation or delay of cases. The aim of this study was to find out how tests ordered in Komfo Anokye Teaching Hospital (K.A.T.H.) by the surgeons affected the decisions of the anaesthetists in the perioperative management of the patients. Methodology: This was a prospective, cross sectional study of patients undergoing elective surgery at K.A.T.H from 1st to 31st March 2014. A quantitative technique was used to effectively quantify laboratory results that were contained in a patient’s folder before an elective surgical procedure. A close and open-ended questionnaire was developed and answered by reviewing patient’s folders during the pre-anesthesia assessment. Data were analyzed using Statistical Package of Social Sciences (SSPS) version 22. Results: The average age of patients studied was 50 years. Abnormal test results did not influence the anaesthetic management in 70.5% of cases but led to either delay or cancelation of cases or requirement for transfusion of blood or blood products in 29.5% of cases. Conclusion: Preoperative laboratory tests ordered by Surgeons in KomfoAnokye Teaching Hospital do not significantly influence the anaesthetic managements of patients.