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EVALUACION PREOPERATORIA DEL PACIENTE EN CIRUGIA PROGRAMADA. INDICACIONES DE LAS PRUEBAS DE LABORATORIO

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Las pruebas rutinarias de laboratorio deben ser solicitadas por el anestesiólogo únicamente cuando en la historia clínica exista algún factor de riesgo que haga necesaria su indicación.
garciami9.jpg Autor:
F. javier García miguel
Columnista Experto de SIIC
Artículos publicados por F. javier García miguel
Coautor
Ana Domínguez Ruíz-Huerta* 
Licenciada en Medicina y Cirugía. Médico Residente en Anestesiología y Reanimación*
Recepción del artículo
4 de Febrero, 2004 		Primera edición
14 de Junio, 2004 		Segunda edición, ampliada y corregida
7 de Junio, 2021

EVALUACION PREOPERATORIA DEL PACIENTE EN CIRUGIA PROGRAMADA. INDICACIONES DE LAS PRUEBAS DE LABORATORIO

Resumen
Objetivos: Establecer un protocolo consensuado de solicitud de pruebas de laboratorio preoperatorias en cirugía programada. Revisar la evidencia científica disponible en la literatura acerca del tema en pacientes sanos asintomáticos y con enfermedad concomitante. Material y métodos: Mediante la técnica Delphy se obtuvo el consenso entre 40 miembros de las especialidades de Anestesiología y Reanimación y Cirugía General, respectivamente, para elaborar un protocolo de solicitud de pruebas preoperatorias para evaluar el estado general del paciente antes de cirugía programada. La búsqueda para identificar artículos relevantes incluyó la revisión de las siguientes bases de datos: Medline, Embase, Biological Abstracts, Science Citation Index, Cochrane Library, informes de las Agencias de Evaluación de Tecnologías Sanitarias y el National Institute for Clinical Excellence. Resultados: El 100% de los profesionales creyeron necesario evaluar preoperatoriamente todos los pacientes y establecer recomendaciones para la solicitud de las pruebas de laboratorio antes de la cirugía programada. El 85.3% consideró que dicho protocolo aportaría mayor cobertura médico-legal y el 94.2% opinó que un cuestionario sería útil para identificar pacientes sanos y asintomáticos. El período de validez del estudio oscilaría entre 3 y 12 meses en pacientes sanos y sintomáticos, respectivamente. Conclusiones: Aunque la prevalencia de anomalías encontradas en las pruebas de laboratorio es elevada no existen datos científicos que justifiquen su solicitud rutinaria. Estas deben ser solicitadas por el anestesiólogo únicamente cuando en la historia clínica exista algún factor de riesgo que haga necesaria su indicación.

Palabras clave
Valoración preoperatoria, cirugía programada, pruebas preoperatorias, electrocardiograma, garantía de calidad, efectividad, pruebas de laboratorio


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Especialidades
Principal: Anestesiología
Relacionadas: Cardiología, Cuidados Intensivos, Diagnóstico por Laboratorio, Medicina Interna



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