Last update 2004

 


PROFESSIONAL ASSOCIATION OF ANAESTHESIOLOGISTS OF BARCELONA
Headquarters: c/ Doctor Rizal 8, 2º2ª, 08006 Barcelona

ADDITIONAL PREOPERATIVE TESTS REQUEST FORM

Mr./Mrs.:……………………………………………………………............................
scheduled to undergo (specify type of surgery): ……………………………………………………………...
on (specify date) …………………………. at ……………………………………………………………….
should undergo the additional tests marked below: Requesting physician: ……………………………

 

  Preoperative requirements recommended by the A.A.B (Professional Association of Anaesthesiologists of Barcelona
ASA I

• Patients with no associated pathology
• Patients aged 1 to 40 years
• Minor surgery

Preanaesthesia assessment
Coagulation test (platelets, APTT/PTT)
ECG > 40 years
ASA II

• Patient with moderate associated pathology (compensated diabetes; controlled hypertension, arrhythmias, asymptomatic valvulopathies)
• Non-morbid obesity
• Heavy smokers

• Children < 1 any

ASA I + tests
 
Haemogram  
Glycemia
· Pts.> 60 years
· Lund pathol.
· Cardiac pathol
· Neoplasia
Creatinine .
Thorax X-ray
ECG.
ASA III

• Patients with compensated severe associated pathology, with no physical impairment (angor, AMI > 6 month, cardiac insufficiency, stable COPD)
• Hepatopathology or significant enolism
• Major surgery

ASA II tests +
Liver panel (ALT, AST)
Iongram (Na + , K + )  
ASA IV
• Patient with decompensated severe associated pathology, with physical impairment • High risk surgery
  ASA III tests +
T otal proteins

 

  Special tests
Blood reservation request form _______
 Self-transfusion : Bone bank:
Respiratory function tests:
(Arterial blood gases, if unable to perform these tests)

• Respiratory pathology
• Heavy smokers (=40 cigarettes/day)
• Morbid obesity
• Thoracic surgery or upper abdomen surgery

Echocardiogram :

• Valvuloplasty
• Ischemic pathology
• Cardiac insufficiency

 

  Notas
Informed Consent for surgery obtained

Informed Consent for anaesthesia obtained

REGULAR MEDICATION:
DISCONTINUE
· ACEIs 24 hours before
·AAS (aspirin) and/or antiaggregants: 10 days before
·MAOIs (antidepressants): Consultation with haematology
·Anticoagulants: Consultation with haematology
·Other ongoing treatments  
   
  DO NOT DISCONTINUE      

The tests are valid for 6 months in stable patients