Abit TOKER, NERMİN KELEBEK GİRGİN, Gürkan TÜRKER, Oya KUTLAY

Küçük ve orta cerrahi girişimlerde preoperatif rutin laboratuar testleri gerekli midir?

Elektif cerrahi girişim planlanan olguların değerlendirilmesinde preoperatif laboratuar testleri yaygın olarak kullanılmaktadır. Çalışmamızda, ASA I-II grubu, elektif küçük ve orta cerrahi girişim planlanan, 40 yaş üstü olgularda preoperatif testlerin gerekliliğini belirlemeyi amaçladık. Kırk yaş üstü, ASA I-II grubu, küçük ve orta cerrahi girişim planlanan, 140 olgu çalışmaya alındı. Olgular 40-59 yaş (Grup I) ile 60 yaş ve üzeri (Grup II) olarak iki eşit gruba ayrıldı. Olguların akciğer radyografisi, elektrokardiografi, hemoglobin, lökosit, trombosit, kan şekeri, sodyum, potasyum, aspartat transaminaz, alanin transaminaz, üre ve kreatinin sonuçları incelendi. Öykü ve fizik muayeneleri değerlendirildi. Balans anestezi uygulanan olgular, peroperatif dönemde ve postoperatif 24 saat takip edilerek, karşılaşılan sorunlar kaydedildi. Grup I’de üre ve kadın olgularda hemoglobin dışındaki testlerin, Grup II’de ise elektrokardiografi, akciğer radyografisi, üre, kan şekeri ve hemoglobin sonuçlarının peroperatif ve postoperatif dönemde hastaya yaklaşımı etkilediği saptandı. Preoperatif tetkiklerin, hasta öykü ve fizik muayene bulgularına göre selektif olarak istenebileceği sonucuna varıldı.

Are preoperative routine laboratory tests necessary in minor and moderate surgical procedures?

Preoperative routine tests are commonly used to evaluate patients who will have planned elective surgical procedure. In this study, we aimed to identify the preoperative tests required for ASA I-II patients, over 40 years old, who will undergo elective minor and moderate surgeries. Totally 140 patients were included in the study. They were separated into 2 groups equally [Group I (40-59 years) and Group II (≥60 years)] according to their ages. The patients’ preoperative tests; including chest radiography, electrocardiography, hemoglobin, white blood cell, platelets, glucose, sodium, potassium, aspartate transaminase, alanine transaminase, ürea and creatinine were evaluated together with history and physical examination. After routine monitoring, balance anaesthesia was performed. The patients were followed during the peroperative and postoperative 24 hours for any problems occurred. In Group I; excluding ürea in both male and female patients and haemoglobin in only female patients; preoperative tests had no effect on the management of the asymptomatic patients. In Group II; electrocardiography, chest radiography, ürea, glucose and hemoglobin tests effected the management of the patients in the preoperative and postoperative period. In conclusion, preoperative tests could be ordered according to history and physical examination of the patients.

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