Outcome of the Preoperative Screening Investigations in Individuals Going in for Elective Surgeries - Dissertation Example

This is because, surgery is always associated with some risk for the patient, both due to the procedure and the anesthesia administered for the procedure. Whatever the level of risk, due to medico-legal implications, every anesthetist performs a detailed evaluation of the patient before shifting to the operating room. Evaluation includes detailed history taking about the present disease, past diseases, medications that the patient is taking, known allergies to any drugs, family history of any significant health ailments, and personal histories like drugs, alcohol, and smoking.

The evaluation also includes a review of previous investigations, detailed physical examination, and laboratory testing. In many parts of the world, there are protocols for routine laboratory testing like complete blood pictures, serum electrolytes, BUN and creatinine, liver function tests, urine analysis, chest X-ray, and electrocardiogram (Garcia et al, 2003). However, there are reports and more and more studies are pointing to the fact that these routine investigations have no role in ascertaining fitness for surgery in otherwise healthy individuals posted for elective surgery.

The experts think that investigations must be considered only on an individual basis because; the percentage of abnormal reports from the tests is minimal and even when abnormalities are detected no change is done in the perioperative management of the surgical patient. Another important aspect of routine testing is that it does not stratify and predict perioperative complications (Narr et al, 1997), thus, defeating the very purpose of preoperative testing. They are also costly and add to health care (Narr et al, 1991).

In this review, the impact and clinical outcomes of preoperative screening investigations in otherwise healthy individuals posted for elective surgery will be discussed through review and critical analysis of suitable literature. The main aim of the study is to ascertain the outcome of routine preoperative testing in otherwise healthy individuals for elective surgeries. 

Materials and methods To find pertinent literature studies, the initial literature searches progress was conducted in the various databases, Blackwell-Synergy, CINAHL, CMJA, Cochrane, EMBASE, Health Reference Center Academic, Internures, MD Consult, Mosby’s Nursing Consult, Proquest5000, ScienceDirect. It was found that numerous articles were available. To further analyze a manageable number of the quality and acceptability of the research articles, inclusion criteria were conducted in the following search strategy.

The applicable key terms were combined using a thesaurus, truncation, Boolean operators, and another limit, such as language, subject fields of the journal, and years of publication in the search strategy. For example, “preoperative”, “preop”, or “screening for surgery” combined with “investigations”, “laboratory tests”, “tests”, or “assessment” as title and text words were utilized in the search strategy. Also, it includes studies published from 1985 to 2011, health, medicine, and nursing fields, and English language articles.