Preoperatorio pruebas
Una Recomendación de No Hacer es una indicación de abandonar una práctica clínica de escaso valor. El escaso valor lo determina el hecho de que la práctica no reporte ningún beneficio conocido para los pacientes y/o les ponga en riesgo de sufrir daños y además pueda suponer un derroche de recursos, sanitarios y/o sociales.
Las Recomendaciones de NO Hacer incluidas en el Catálogo son las que cumplen todos estos criterios.
Para solicitar la inclusión en el Catálogo, es preciso cumplimentar el formulario.
Ver más información sobre la Iniciativa NO Hacer
No solicitar pruebas analíticas preoperatorias en pacientes pediátricos sanos, programados para procedimientos o cirugías menores, salvo que la exploración física y anamnesis lo justifiquen
Sociedad Científica: Sociedad Española de Cirugía Pediátrica (SECP)
https://portal.guiasalud.es/wp-content/uploads/2026/07/rnh_114_222.pdf
Choosing Wisely USA. Don´t perform routine preoperative hemostatic testing in an otherwise healthy child with no previous personal or family history of bleeding. American Society of Hematology (ASH) and American Society of Pediatric Hematology/Oncology (ASPHO). 2019.
https://ashpublications.org/bloodadvances/article/6/2/679/483556/The-ASH-ASPHO-Choosing-Wisely-Campaign-5
National Institute for Health and Care Excellence. Intravenous fluid therapy in children and young people in hospital. London: NICE; 2015.
O'Connor ME, Drasner K. Preoperative laboratory testing of children undergoing elective surgery. Anesth Analg. 1990 Feb;70(2):176-80.
Recommendations | Intravenous fluid therapy in children and young people in hospital| Guidance | NICE [Internet]. NICE; 2016 [citado 25 febrero de 2025]. Disponible en: https://www.nice.org.uk/guidance/ng29
Hackmann T, Steward DJ, Sheps SB. Anemia in pediatric day- surgery patients: prevalence and detection. Anesthesiology 1991;75:27 – 31.
Roy WL, Lerman J, McIntyre BG. Is preoperative hemoglobin testing justified in children undergoing minor elective surgery? Can J Anaesth 1991;38:700–3.
Mallick MS. Is routine pre-operative blood testing in children necessary? Saudi Med J. 2006 Dec;27(12):1831-4. PMID: 17143358.
Serafini G, Ingelmo PM, Astuto M, et al.; Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care (SARNePI). Preoperative evaluation in infants and children: recommendations of the Italian Society of Pediatric and Neonatal Anesthesia and Intensive Care (SARNePI). Minerva Anestesiol. 2014; 80(4): 461-469.
Basel A, Bajic D. Preoperative evaluation of the pediatric patient. Anesthesiol Clin. 2018; 36(4): 689-700.
Asaf T, Reuveni H, Yermiahu T, et al. The need for routine pre-operative coagulation screening tests (prothrombin time PT/partial thromboplastin time PTT) for healthy children undergoing elective tonsillectomy and/or adenoidectomy. Int J Pediatr Otorhinolaryngol. 2001;61(3):217-222.
Alzahrani A, Othman N, Bin-Ali T, et al. Routine preoperative coagulation tests in children undergoing elective surgery or invasive procedures: Are they still necessary? Clin Med Insights Blood Disord.2019;12:1179545X18821158.
Chee YL, Crawford JC, Watson HG, Greaves M; British Committee for Standards in Haematology. Guidelines on the assessment of bleeding risk prior to surgery or invasive procedures. Br J Haematol. 2008;140(5):496-504.
Becke K, Eich C, Höhne C, Jöhr M, Machotta A, Schreiber M, Sümpelmann R. Choosing Wisely in pediatric anesthesia: An interpretation from the German Scientific Working Group of Paediatric Anaesthesia (WAKKA). Paediatr Anaesth. 2018 Jul;28(7):588-596. doi: 10.1111/pan.13383. Epub 2018 May 30. PMID: 29851190.
Fletke KJ, Kaysin A, Jones S. Preoperative Evaluation in Children. Am Fam Physician. 2022 Jun 1;105(6):640-649.
No hacer una radiografía de tórax en el estudio preoperatorio de un paciente joven sano.
Sociedad Científica: Sociedad Española de Traumatología y Cirugía Ortopédica (SECOT)
García- Miguel FJ, García Caballero J, Gómez de Caso Canto JA. Indicaciones de la radiografía de tórax para la valoración preoperatorio en cirugía programada. Rev Esp Anestesiol Reanim 2002;49:80-8.
Siriussawakul A, Nimmannit A, Rattana-arpa S et al. Evaluating compliance with institucional preoperative testing guidelines for minimal-risk patients undergoing elective surgery. Hindawi Publishing Corporation. BioMed Research International. Volume 2013, Article ID 835426.
Feely MA, Collins CS, Daniels PR, Kebede EB, Jatoi A, Mauck KF. Preoperative testing before non cardiac surgery: Guidelines and recomendations. Am Fam Physician 2013;87(6):414-8
No realizar pruebas de laboratorio (hemograma, bioquímica y estudio de coagulación) en pacientes sin enfermedad sistémica (ASA I y II) previo a cirugías de bajo riesgo, con pérdida estimada de sangre mínima.
Sociedad Científica: Reanimación y Terapéutica del Dolor (SEDAR), Sociedad Española de Anestesiología
Guidelines for pre-operative cardiac risk assessment and perioperative cardiac Management in non-cardiac surgery. The Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-Cardiac Surgery of the European Society of Cardiology (ESC) and endorsed by the European Society of Anaesthesiology (ESA). European Heart Journal 2009; 30:2769a.
American Society of Anesthesiologists Task Force on Preanesthesia Evaluation. Practice Advisory for preanesthesia evaluation. Anesthesiology 2002;96(2):485-496.
Feely MA, Collins S, Daniels PR et al. Preoperative testing before noncardiac Surgery: Guidelines and recommendations. Am Fam Physician 2013;87(6):414-8.
López Argumedo M, Asua J. Preoperative Evaluation in elective surgery. (INAHTA Synthesis Report). Vitoria-Gasteiz. Dpto of Health Basque Government. Basque Office of Health Technology Assessment, Osteba 1999.
No realizar radiografía de tórax en menores de 40 años con bajo riesgo anestésico (ASA I o II).
Sociedad Científica: Reanimación y Terapéutica del Dolor (SEDAR), Sociedad Española de Anestesiología
Joo HS, Wong J, Naik VN, Savoldelli GL. The value of screening preoperative Chest X-rays: a systematic review. Can J Anaesth 2005;52(6):568-574.
López Argumedo M, Asua J. Preoperative Evaluation in elective surgery. (INAHTA Synthesis Report). Vitoria-Gasteiz. Dpto of Health Basque Government. Basque Office of Health Technology Assessment, Osteba 1999.
The use of routine preoperative test for elective Surgery. June 2003 NICE Clinical Guideline Nº3 (CG3). Update in 2016 Clinical Guideline (CG45).
No realizar, de manera sistemática, pruebas preoperatorias en cirugía de cataratas, salvo indicación basada en historia clínica y exploración física.
Sociedad Científica: Reanimación y Terapéutica del Dolor (SEDAR), Sociedad Española de Anestesiología
Schein OD, Katz J, Bass EB, Tielsch JM, Lubomski LH, Feldman MA et al. The value of Soutine preoperative medical testing befote cataract surgery. Study of Medical Testing for Cataract Surgery. N Eng J Med 2000;342(3):168-75.
Keay L, Lindsley K, Tielsch J, Katz J, Schein O. Routine preoperative medical testing for cataract surgery. Cochrane Database of Systematic Review 2012(3):CD007293.
Kelly SP. Guidance on patient safety in ophthalmology from the Royal College of Ophthalmologists. Eye 2009;23:2143-2151.
