Labrador ÁPR, Sánchez TM, Piedra TC, Díaz FL, Cruz CM

Language: Spanish
References: 13
Page: 1-7
PDF size: 373.50 Kb.

ABSTRACT

Introduction: The selection of preoperative laboratory tests (specific tests or imaging tests) should be done, as a complementary measure, in the case of clinical suspicion. Indiscriminate and routine request is unnecessary and implies additional costs for the institution, in addition to the possibility of false positive results, with more or less serious repercussions for patients.
Objective: To highlight the results and the clinical-anesthetic repercussion of complementary preoperative examinations in ASA-I patients who arrive for ambulatory surgery at Commandant Pinares General Teaching Hospital in San Cristóbal Municipality, Artemisa Province, during the year 2017.
Method: An observational, descriptive, cross-sectional study was carried out at Commandant Pinares General Teaching Hospital in San Cristóbal Municipality, Artemisa Province, during the year 2017. The universe was represented by 823 patients who underwent ambulatory surgery. The sample consisted of 394 patients, following nonprobabilistic, intentional selection criteria.
Results: The sex with the highest prevalence of surgeries was the female sex (65.98%). The most frequent ages were between 18 and 30 years. The most performed elective surgery was cholecystectomy (43.18%). Regarding the paraclinical examinations performed, a low incidence of alterations was detected; the perioperative complication detected was hypertensive crisis (0.50%).
Conclusion: The results of the complementary examinations were normal in most of the patients, without repercussions or changes in the clinical anesthetic behavior. In addition, they generated high expenses for the health institution.
Keywords: complementary tests; ASA-I patients; ambulatory surgery; clinical practice guides

REFERENCES

1. Recart A. Cirugía mayor ambulatoria una nueva forma de entender la medicina quirúrgica. Rev Méd Clín Las Condes. 2017[acceso: 12/02/2020];28(5):649-812. Disponible en: Disponible en: https://www.elsevier.es/es-revista-revista-medica-clinica-las-condes-202-articulo-cirugia-mayor-ambulatoria-una-nueva-S0716864017301256

2. Dirección de Registros Médicos y Estadísticas de Salud. Anuario Estadístico de Salud 2015. La Habana: MINSAP; 2016. p. 14.

3. Recart A. Cirugía ambulatoria en Latinoamérica: desafíos y oportunidades. Cir May Amb. 2015[acceso: 12/02/2020];20(2):88-9. Disponible en: Disponible en: http://www.asecma.org/Documentos/Articulos/09_20_2_AE_Recart.pdf

4. Katz RI, Dexter F, Rosenfeld K, Wolfe L, Redmond V, Agarwal D, et al. Surveystudy of anesthesiologists and surgeons ordering of unnecessary preoperative laboratory tests. Anesth Analg. 2011[acceso: 12/02/2020];112(1):207-12. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/21081771/

5. Apfelbaum JL, Connis RT, Nickinovich DG, Pasternak LR, Arens JF, Caplan RA, et al. Practice advisory for preanesthesia evaluation: an updated report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Anesthesiology. 2012[acceso: 12/02/2020];116(3):522-38. Disponible en: Disponible en: https://anesthesiology.pubs.asahq.org/article.aspx?articleid=2443414

6. De Hert S, Imberger G, Carlisle J, Diemunsch P, Fritsch G, Moppett I, et al. Preoperative evaluation of the adult patient undergoing non-cardiac surgery: guidelines from the European Society of Anaesthesiology. Eur J Anaesthesiol EJA. 2011[acceso: 12/02/2020];28(10):684-722. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/2188598/

7. National Institute for Health and care Excellence. Routine preoperative tests for elective surgery NICE guideline. Published. 2016[acceso: 16/05/2019]. Disponible en: Disponible en: https://www.nice.org.uk/guidance/ng45/resources/routine-preoperative-tests-for-elective-surgery-pdf-1837454508997

8. Nazar JC, Bastidas EJ, Lema FG. Exámenes preoperatorios de rutina en cirugía electiva: ¿Cuál es la evidencia? Rev Chil Cir. 2014[acceso: 12/02/2020];66(2):188-93. Disponible en: Disponible en: https://scielo.conicyt.cl/scielo.php?script=sci_arttext&pid=S071840262014000200017

9. Böhmer AB, Wappler F, Zwissler B. Preoperative risk assessment-from routine tests to individualized investigation. Dtsch Ärztebl Int. 2014[acceso: 12/02/2020];111(25):437-45. Disponible en: Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4095591/

10. Vlayen J, Benahmed N, Robays J. Routine preoperative testing in adults undergoing elective non-cardiothoracic surgery. Good Clinical Practice. 2017[acceso: 16/05/2019];280:1-67. Disponible en: Disponible en: https://pubmed.ncbi.nlm.nih.gov/29722491/

11. Reazaul Karim H. Practice and reasons for routine pre-operative investigations among anaesthesiologists and surgeons: (c) 2017. Indian J Anaesth. 2017[acceso: 16/05/2019];61(11):933-5. Disponible en: Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5703009/

12. Karim HM, Yunus M, Bhattacharyya P. An observational cohort study on pre-operative investigations and referrals: How far are we following recommendations? Indian J Anaesth. 2016[acceso: 16/05/2019];60(8):552-9. Disponible en: Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4989805/

13. Cuadrado Cenzual MA, Ortega Madueño I. Utilidad de las pruebas diagnósticas en la práctica clínica: medicina de laboratorio basada en la evidencia. Asociación Española de Biopatología Médica. 2012[acceso: 15/10/2014]. Disponible en: Disponible en: https://docplayer.es/5700631-Utilidad-de-las-pruebas-diagnosticas-en-la-practica-clinica-medicina-de-laboratorio-basada-en-la-evidencia.html