Is preoperative haemoglobin testing justified in children undergoing minor elective surgery?

The need for preoperative haemoglobin determination before the administration of general anaesthesia to paediatric patients has long been an issue for debate. This study was undertaken to determine the value of routine preoperative haemoglobin testing in paediatric patients scheduled for minor surgery. Two thousand patients ages one month to 18 yr scheduled for minor surgery were studied. The patients were grouped according to age, Group I less than or equal to yr, Group II 1-5 yr, Group III greater than 5 yr. The charts of patients whose preoperative haemoglobin concentration (Hb) was less than 100 g.L-1 were reviewed at a later date to determine the course of their anaesthesia and surgery. Eleven patients, all of whom were greater than 5 yr (0.5%), had a Hb less than 100 g.L-1. Of these, three patients, 27%, had their surgery deferred, whereas the remaining eight patients, 73%, underwent anaesthesia and surgery without complications. The three patients who were deferred returned for uneventful anaesthesia and surgery following oral iron therapy. We conclude that healthy paediatric patients five years and older scheduled for minor surgery do not require routine Hb determinations. Furthermore, the low incidence of anaemia and low deferral rate of anaemic children, 1-5 yr of age, lead us to question the value of preoperative Hb testing in this age group.