Preoperative laboratory screening in healthy children: What is necessary?

This study was designed to evaluate the current practice of preoperative laboratory testing in healthy children undergoing elective surgery in a single tertiary general hospital, and compare it to the guidelines published by the American and Israeli societies of pediatric anesthesia. We also evaluated the effects of a pre-designed educational program on that practice. This was a prospective, two stage study. In stage one, data was collected on the practice of the preoperative laboratory tests obtained from children scheduled for elective surgeries. We then conducted training, dedicated to criteria and indications for preoperative laboratory testing in children prior to elective surgery. Following the training, we conducted a second phase observation and data on a second group of children was collected and analyzed Comparing the two groups of children enabled the evaluation of the benefit of the pre-designed educational program. Two hundred and forty children scheduled for elective surgery during the four months of the study period, were surveyed. In stage one, we enrolled and documented preoperative laboratory data obtained for 150 children. In stage two, we collected data on 90 children. Overall, the incidence of unnecessary laboratory tests in the preoperative period was reduced significantly (by 32.5%, p < 0.001). The incidence of non-indicated tests performed, was also reduced significantly (by 23.1%, P = 0.015). We conclude that the use of unnecessary testing of children before elective surgery is common. A training program designed to address this issue can lead to a reduction in unnecessary testing.