Pemeriksaan laboratorium rutin sebelum tindakan bedah (pre operatif) menurut The American Society of Anesthesiologist (ASA) merupakan pemeriksaan yang dilakukan tanpa indikasi atau tujuan spesifik, dimana status praoperasi atau skrining bedah tidak dianggap sebagai indikasi atau tujuan klinis tertentu.[1] Sedangkan tindakan bedah elektif adalah tindakan pembedahan yang telah dijadwalkan sebelumnya dan bukan merupakan tindakan emergensi.[2]
Pemeriksaan laboratorium pre operatif, termasuk yang dilakukan sebelum tindakan bedah elektif, selayaknya bertujuan untuk mengurangi morbiditas dan mortalitas pada pasien yang menjalani tindakan pembedahan, menilai risiko dan pemilihan tindakan anestesi, serta menentukan manajemen post operatif. Hal-hal tersebut akan tercapai jika pemeriksaan tersebut dilakukan dengan bijak.[3,4]
Berbagai pedoman tidak lagi merekomendasikan pemeriksaan laboratorium rutin sebelum menjalani tindakan bedah elektif pada risiko rendah.[1,2,4-6]. Beberapa tindakan bedah minor yang tidak membutuhkan pemeriksaan pre operatif antara lain: eksisi lesi kulit, eksisi kelenjar bartholin, membebaskan carpal tunnel, sirkumsisi, repair hydrocele, operasi katarak, dan drainase abses payudara. Meski begitu, dalam praktiknya pemeriksaan laboratorium rutin preoperatif sebelum tindakan bedah elektif tetap lazim dilakukan.[7]
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Referensi
1. American Society of Anesthesiologists. Practice Advisory for Preanesthesia Evaluation An Updated Report by the American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Anesthesiology. 2012(116)1-17. http://www.asahq.org/~/media/sites/asahq/files/public/resources/standards-guidelines/practice-advisory-for-preanesthesia-evaluation.pdf
2. O’Neill F, Carter E, Pink N, Smith I. Routine preoperative tests for elective surgery: summary of updated NICE guidance. BMJ. 2016(354)1-4. https://www.bmj.com/content/354/bmj.i3292
3. Soares DS, Brandao RRM, Mourao MRN, Azevedo VLF, Figueiredo AV, Trindade ES. Relevance of routine testing in low-risk patients undergoing minor and medium surgical procedures. Braz J Anesthesiol. 2013(63)197-201. https://www.ncbi.nlm.nih.gov/pubmed/23601261
4. Feely MA, Collins CS, Daniels PR, Kebede EB, Jatoi A, Mauck KF. Preoperative Testing Before Noncardiac Surgery: Guidelines and Recommendations. Am Fam Physician. 2013(87)414-418. https://www.ncbi.nlm.nih.gov/pubmed/23547574
5. Vlayen J, Benahmed N, Robays J. Routine preoperative testing in adults undergoing elective non-cardiothoracic surgery. Good Clinical Practice Brussels: Belgian Health Care Knowledge Centre. 2016. https://kce.fgov.be/sites/default/files/atoms/files/KCE_280_Routine_preoperative_testing_Report.pdf
6. Medscape. Preoperative Testing. https://emedicine.medscape.com/article/285191-overview
7. Karim HMR, Practice and reasons for routine pre-operative investigations among anaesthesiologists and surgeons: An online survey. Indian J Anaesth. 2017(61)933–935. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5703009/
8. Guttikonda N, Nileshwar A, Rao M, Sushma TK. Preoperative laboratory testing - Comparison of National Institute of Clinical Excellence guidelines with current practice - An observational study. J Anaesthesiol Clin Pharmacol. 2019(35)227-230. https://www.ncbi.nlm.nih.gov/pubmed/31303713
9. Farid AF, Suwondo BS, Pratomo BY. Evaluasi pemeriksaan laboratorium preoperatif pada pasien operasi elektif asa i dan ii di gbst rsup dr sardjito. Universitas Gajah Mada. Yogyakarta. 2015. http://etd.repository.ugm.ac.id/index.php?mod=penelitian_detail&sub=PenelitianDetail&act=view&typ=html&buku_id=91621&obyek_id=4
10. Benarroch-Gampel J, Sheffield KM, Duncan CB, Brown KM, Han Y, Townsend CM Jr, et al. Preoperative laboratory testing in patients undergoing elective, low-risk ambulatory surgery. Ann Surg. 2012(256):518-28. https://www.ncbi.nlm.nih.gov/pubmed/22868362
11. Houchens N. Do healthy patients need routine laboratory testing before elective noncardiac surgery? Cleve Clin J Med. 2015(82)664-6. https://www.ncbi.nlm.nih.gov/pubmed/26469822
12. American Academy of Ophtalmology. Routine Preoperative Laboratory Testing for Patients Scheduled for Cataract Surgery - 2014. https://www.aao.org/clinical-statement/routine-preoperative-laboratory-testing-patients-s
13. Kumar A, Srivasta U. Role of routine laboratory investigations in preoperative evaluation. J Anaesthesiol Clin Pharmacol. 2011(27)174-9.
14. Brown SR, Brown J. Why do physicians order unnecessary preoperative tests? A qualitative study. Fam Med.. 2011(43)338-43. https://www.ncbi.nlm.nih.gov/pubmed/21557104