Introduction — This topic includes links to society and government-sponsored guidelines from selected countries and regions around the world. We will update these links periodically; newer versions of some guidelines may be available on each society's website. Some societies may require users to log in to access their guidelines.
The recommendations in the following guidelines may vary from those that appear in UpToDate topic reviews. Readers who are looking for UpToDate topic reviews should use the UpToDate search box to find the relevant content.
Links to related guidelines are provided separately. (See "Society guideline links: Preoperative fasting" and "Society guideline links: Perioperative cardiovascular evaluation and management" and "Society guideline links: Preoperative evaluation and perioperative management of patients with rheumatic diseases".)
Canada
●Canadian Anesthesiologists' Society (CAS): Guidelines to the practice of anesthesia, revised edition (2022)
●Choosing Wisely Canada: Anesthesiology – Five things physicians and patients should question (2020)
●Choosing Wisely Canada: Avoid routine preoperative laboratory testing for low risk surgeries without a clinical indication (2020)
●Choosing Wisely Canada: Don't routinely perform preoperative testing (such as chest X-rays, echocardiograms, or cardiac stress tests) for patients undergoing low risk surgeries (2020)
United States
●American Academy of Pediatrics (AAP): Policy statement on the pediatrician's role in the evaluation and preparation of pediatric patients undergoing anesthesia (2014, reaffirmed 2021)
●Choosing Wisely: Avoid routine preoperative testing for low risk surgeries without a clinical indication (2013, updated 2021)
●Society for Ambulatory Anesthesia (SAMBA): Position statement on preoperative care for cataract surgery (2021)
●Choosing Wisely: Don't perform routine pre-operative hemostatic testing (PT, aPTT) in an otherwise healthy child with no prior personal or family history of bleeding (2019)
●Institute for Clinical Systems Improvement (ICSI): Perioperative guideline (2019)
●Choosing Wisely: Don't perform routine pre-operative testing before low-risk surgical procedures (2013, revised 2017)
●American Geriatrics Society (AGS): Optimal perioperative management of the geriatric patient (2015)
●American Society of Anesthesiologists (ASA): Basic standards for preanesthesia care (2015)
●ASA: Practice guidelines for perioperative blood management – An updated report (2015)
●American College of Cardiology (ACC)/American Heart Association (AHA): Guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery (2014)
●ASA: Practice guidelines for the perioperative management of patients with obstructive sleep apnea – An updated report (2014)
●ACC/AHA: Guideline on the assessment of cardiovascular risk (2013)
●American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP)/AGS: Best practices guidelines on the optimal preoperative assessment of the geriatric surgical patient (2013)
●Choosing Wisely: Avoid echocardiograms for preoperative/perioperative assessment of patients with no history or symptoms of heart disease (2013)
●Choosing Wisely: Don't obtain baseline diagnostic cardiac testing (trans-thoracic/esophageal echocardiography − TTE/TEE) or cardiac stress testing in asymptomatic stable patients with known cardiac disease (eg, CAD, valvular disease) undergoing low or moderate risk non-cardiac surgery (2013)
●Choosing Wisely: Don't obtain baseline laboratory studies in patients without significant systemic disease (ASA I or II) undergoing low-risk surgery – specifically complete blood count, basic or comprehensive metabolic panel, coagulation studies when blood loss (or fluid shifts) is/are expected to be minimal (2013)
●Choosing Wisely: Don't perform preoperative medical tests for eye surgery unless there are specific medical indications (2013)
●Choosing Wisely: Don't perform cardiac imaging as a pre-operative assessment in patients scheduled to undergo low- or intermediate- risk non-cardiac surgery (2012)
Europe
●European Society of Cardiology (ESC): Guidelines on cardiovascular assessment and management of patients undergoing non cardiac surgery (2022)
●European Society of Anaesthesiology (ESA): Updated guideline on pre-operative evaluation of adults undergoing elective noncardiac surgery (2018)
●ESA: Guidelines for the management of severe perioperative bleeding (2016)
United Kingdom
●Royal College of Anaesthetists (RCOA): Guidelines for the provision of anaesthesia services for preoperative assessment and preparation (2019)
●Choosing Wisely UK: Royal College of Anaesthetists & Royal College of Surgeons England – Patients choosing surgery who are at a high risk of dying after an elective surgical procedure (predicted 30-day mortality of greater than 1%) should be identified by their age, type of surgery and coexisting medical conditions. They should have a shared decision-making consultation to discuss their individual chance of benefit or harm and to identify their personal preference (2016)
●Choosing Wisely UK: Royal College of Anaesthetists & Royal College of Surgeons England – Healthy patients having planned minor or intermediate surgery do not need routine preoperative tests. NICE guideline should be used (NG 45) to help determine which tests are appropriate (2016)
●Choosing Wisely UK: Royal College of Anaesthetists & Royal College of Surgeons England – With the appropriate preoperative assessment and preparation elective surgical patients do not need to be admitted to hospital the day before their operation (2016)
●National Institute for Health and Care Excellence (NICE): Guideline on routine preoperative tests for elective surgery (2016)
●British Society for Haematology (BSH): Guidelines on identification and management of pre-operative anaemia (2015)
●Association of Anaesthetists of Great Britain and Ireland (AAGBI): Safety guideline on pre-operative assessment and patient preparation – The role of the anaesthetist (2010)
●British Society for Haematology (BSH): Guidelines for the assessment of bleeding risk prior to surgery or invasive procedures (2008)
Australia-New Zealand
●Choosing Wisely Australia: Avoid initiating anaesthesia for patients with significant co-morbidities without adequate, timely preoperative assessment and postoperative facilities to meet their needs
●Choosing Wisely Australia: Avoid ordering cardiac stress testing for asymptomatic patients prior to undergoing low to intermediate risk non-cardiac surgery
●Choosing Wisely Australia: Avoid routinely performing preoperative blood investigations, chest X-ray or spirometry prior to surgery, but instead order in response to patient factors, symptoms and signs, disease, or planned surgery
●Australian and New Zealand College of Anaesthetists (ANZCA): Guidelines on pre-anaesthesia consultation and patient preparation (2017)
●National Blood Authority (NBA) Australia: Patient blood management guidelines – Module 2: Perioperative (2012)
Japan
●[In Japanese] Choosing Wisely Japan: About preoperative testing – When and when testing is needed (2018)
●[In Japanese] Choosing Wisely Japan: Preoperative cardiac ultrasonography – When needed and when not needed (2018)
●[In English] Japanese Circulation Society (JCS): Guidelines for perioperative cardiovascular evaluation and management for noncardiac surgery, 2014 (published 2017)
●[In Japanese] Choosing Wisely Japan: Pre-operative examination – When needed, when not needed (2017)
