Please confirm that an ethics committee approval has been applied for or granted: Not relevant

Background and Aims Currently, no established guidelines for the necessity and specific parameters of pre-procedure blood tests before neuraxial blockade, and their impact on decision-making remains uncertain.

Methods This single-center retrospective study included patients undergoing neuraxial blockade. Medical information and laboratory data, encompassing hematology, coagulation, liver function, and chemistry tests collected during the pre-procedural period, were extracted from electronic medical records. Patient factors associated with abnormal laboratory tests were identified through multivariate regression analysis using backward elimination.

Results 618 patients were included: hypertension (42.4%), diabetes 15.5%, coronary artery disease or arrhythmia 10.5%, cancer 7.1%, and nephropathy 1.6%. Ten patients were subsequently diagnosed with conditions related to abnormal results during the follow-up period (table 1). Advanced age (p = 0.026) and cancer (p = 0.016) were significantly associated with elevated C-reactive protein (> 0.30 mg/dL). Cancer (p < 0.001) was significantly associated with hyperglycemia (≥ 200 mg/dL). Remarkably, 24 (3.88%) individuals had hyperglycemia (≥ 200 mg/dL). No patients were identified with an INR increase of 1.4 or higher, and no patients showed remarkable abnormal results in PT and PTT. After excluding 15 patients with missing estimated glomerular filtration rate, advanced age (p < 0.001), hypertension (p = 0.012), cancer (p = 0.019), and coronary artery disease or arrhythmia (p < 0.001) were significant predictors of decreased estimated glomerular filtration rate (<60 mL/min/1.73m2) (table 2).

Conclusions Pre-procedure blood tests can offer valuable insights into a patient‘s condition before neuraxial blockade. While patient medical comorbidities may not entirely account for the patient‘s condition, they can guide selective blood test screening.