Definition and Guidelines By NICE For Preoperative Tests

Submitted on March 27, 2012

What Is a Preoperative Test?

Preoperative testing is a set of medical tests that you are required to carry out before you undergo a planned operation (often referred to as 'elective surgery'). These preoperative tests are done even if you otherwise appear to be healthy. They are done to provide information to the surgeons operating on you, about any conditions that you may have, and that could affect the treatment you need.

Preoperative Testing Guidelines

The preoperative tests that will be done before your surgery are determined by your general health, your age, the type of surgery you are going to undergo, any other illnesses or medical health conditions that you presently have or have had in the past, and any medication you are currently taking.

In the early 1980s, there were no guidelines to regulate these tests. Several researchers found that patients undergoing an operation were prescribed a long list of preoperative tests, most of which were not related to or did not in any way influence the surgery. They found that doctors were not good at evaluating the type of preoperative tests required. At the same time, a proper physical examination and a good medical history chart of the patient was required before undergoing an operation, especially a major one.

This led to the National Institute for Clinical Excellence (NICE) to come up with a list of preoperative guidelines.

  • Full blood count (FBC): This measures the hemoglobin and other types of cells in your blood. It is usually done if you are suspected of having anemia. It will help the doctors in giving you greater post-operative care.
  • Blood clotting tests: These tests help to find out how long it takes for your blood to clot, and whether the blood clots normally. This is of great importance during surgery, where heavy bleeding may occur. It is of even greater importance if you are on medication with blood thinning drugs, or if you are on kidney dialysis, or in case you have any disease of the blood vessels (vascular) or liver.
  • Blood gases: This test measures the acidity levels in the blood, along with the oxygen and carbon dioxide. It is especially important in case you suffer from a heart or lung disease.
  • Blood glucose: This test measures the levels of sugar and glucose, and finds out if you are diabetic.
  • Urine dipstick test: This test detects urinary tract infections and checks how the kidneys are functioning. Glucose in the urine gives an indication of diabetes.
  • Kidney function tests: Blood and urine samples are tested to determine that the kidneys are functioning well.
  • Sickle test cell: Persons with sickle cell anemia may have problems when given anesthesia. Therefore a test is essential before any major surgery.
  • Preoperative pregnancy testing: Surgery or anesthesia may harm the unborn baby. Therefore this test is essential to determine pregnancy.
  • Lung function tests: These tests find out whether you are suffering from any lung disease such as bronchitis or asthma, and also how efficiently you breathe.
  • Chest X-ray: This is more important for an older person (over 60) to find out if there is any heart or lung disease.
  • Electrocardiogram (ECG): This is usually done on older persons, and those with previous heart disease. An abnormal heart rhythm or any other heart problems are detected by means of this test.