*MASROORUDDIN, **SALEEM ULLAH, ***NOOR UL HAQ

ABSTRACT

Objective:The objective of study was to detect the abnormalities and establish the evidence against the routinely ordered preoperative chest radiographs in asymptomatic young adults between 15 - 40 years of age, scheduled for elective non-cardiopulmonary surgery. Study Design: Descriptive study. Place and duration: Study was conducted at anesthesia clinic of Abbasi Shaheed Hospital from August 2004 to August 2005.

Patients and methods: A descriptive study of 725 asymptomatic patients, without risk factors and age ranging between 15 to 40 years scheduled for elective non-cardiopulmonary surgery was conducted at Abbasi Shaheed Hospital over a period of one year. Routine chest radiograph define as these ordered for asymptomatic healthy individuals in the absence of any clinical indication and not a candidate for major vascular, abdominal, thoracic surgery. In the study we analyzed the routinely ordered chest X-rays to detect any abnormality. The abnormalities detected on chest X-rays films were classified as significant and insignificant. Data showed insignificant abnormalities do not influence the management of anesthesia.

Results: The routine preoperative chest radiograph ordered in 725, asymptomatic patients without risk factors scheduled for elective non-cardiopulmonary surgery. The age of individuals were ranging between 15 - 40 years. The abnormalities detected on chest X-rays film were assessed. No significant abnormalities were found in these subjects. In this study we found few insignificant abnormalities includes, borderline cardiomegaly, aortic unfolding, prominent broncho-vascular marking, cervical rib, pleural thickening. These insignificant abnormalities do not influence the peri-operative management of anesthesia. This study support the evidence that routine preoperative chest X-ray in asymptomatic young adults undergoing for elective non cardiopulmonary surgery should be limited to the patients with clinical symptoms and high risk patients. Such routine preoperative chest radiograph should be avoided in young asymptomatic patients.

Conclusion: The routine preoperative chest radiograph is still widely overused in our country. The study suggested that history and physical examination are best way to screen the disease. The data showed that routine chest X-rays in asymptomatic patients scheduled for elective non-cardiopulmonary surgery do not influence the peri-operative management of anesthesia. Our study shows that chest radiograph abnormalities are rare and insignificant in asymptomatic patients, age ranging between 15 - 40 years. Study recommended that investigation should be performed as indicated by clinical finding. The study suggests that routine chest radiograph is unnecessary in asymptomatic patient age ranging 15 - 40 years scheduled for elective non-cardiopulmonary surgery.

Keywords: ASA Status (American Society of Anesthetists status)

For Full text contact to:
Prof. Dr. Farah Mansuri
editor@annals-ashkmdc.org

* Asstt: Prof. Anesthesiology.
** Asso. Prof. Medicine.
*** Asstt: Prof. Anesthesia. KMDC & Abbasi Shaheed Hospital, Karachi.