Pre-Operative Blood Testing in the Pediatric Age Group Is It Necessary?

Objectives: To examine the value of pre-operative blood testing in children scheduled to undergo minor elective surgical procedures under general anesthesia; (Day-Case Surgery). Methods: Retrospectively we reviewed the medical records of 430 children who presented for elective minor surgical procedures in the division of pediatric surgery, King Hussein Medical Center, Amman, Jordan from January 2006 to December 2007. Pre-operative investigations (complete blood count, urea and electrolytes) were analyzed in the form of frequency of abnormalities, and the effect of the abnormal results on the procedure. The relationship between the complication and the abnormal results was also examined. Results: During the one year study period, 430 children were subjected to these pre-operative blood tests before minor elective procedures such as inguinal herniotomy, hydrocelectomy, orchidopexy and others. A total of 860 tests were performed, of which 86 (10%) were abnormal. Twelve children had abnormal hemoglobin results (the lowest was 8.5 gm/dl). Thirty-one children had clinically insignificant platelets or white blood cell count. There were 28 abnormal electrolytes results which were very insignificant. No case was postponed due to these investigations. Seven complications arose, none of which could have been predicted by the pre-operative screening tests. Conclusion: These results indicate that pre-operative blood testing in the pediatric age group undergoing elective minor surgical procedures has very limited value in patient management. It may be unpleasant for the patient and the parents. A detailed history and clinical examination are of greater value than routine laboratory tesst in determining a child's fitness for surgery.