Routine Preoperative Investigations

Full Blood Count (CBC)

Not indicated in healthy asymptomatic patients less than 60 years where blood loss is expected to be less than 10% of blood volume. (Blood volume 70 mL/kg.)

Indications may include:

• Major surgery
• Anaemia
• Rheumatoid arthritis
• Cardiovascular disease
• Chronic infection
• Bleeding tendency

• Chronic blood loss
• Chronic renal failure
• Malignancy
• Respiratory disease
• Acute inflammatory conditions
• Malnutrition

Routine Biochemistry (Na, K, Creatinine, Glucose, LFTs)

Not indicated in healthy asymptomatic patients less than 60 years.

Indications may include:

• Major surgery
• On cardiovascular drugs
• Hypertension
• Endocrine disease including diabetes

• Malignancy
• On steroids
• Renal disease
• Liver disease
• Suspected sepsis

CXR

Not indicated in asymptomatic patients.

Indications may include:

• Acute respiratory symptoms or signs
• Worsening existing cardiac or respiratory diseases

• Possible metastases
• Fractured NOF

ECG

Not indicated in asymptomatic males <50 years / females <60 years.

Indications may include:

• Clinical heart disease
• Peripheral vascular disease
• Renal impairment or failure
• Rheumatic heart disease
• Electrolyte abnormality
• Severe chronic respiratory disease

• Diseases associated with cardiac involvement
• Hypertension
• Diabetes mellitus
• Collagen vascular disease
• On digoxin
• Previous chemotherapy

There may be variations to these guidelines for certain surgical subspecialities, e.g., aortic aneurysm repair or specific anaesthetic request.