The standard pre-operative panel — every patient, every time
Eight test groups make up the floor that exists regardless of procedure. Dr. Khaled Ghalwash and Dr. Mohamed Ghalwash order the same baseline for a hernia repair as for a bariatric procedure, because the questions answered here are anaesthesia questions, not surgery questions.
Each test below answers something specific. The page is structured so the patient knows what each tube of blood is for, why ECG is added even for non-cardiac surgery, and what changes if a result comes back outside normal range.
The standard panel, test by test
| Test | What it measures | What changes if abnormal |
|---|---|---|
| Complete Blood Count (CBC) | Red cells, white cells, platelets, haemoglobin | Anaemia delays surgery for iron correction. Low platelets = bleeding risk plan. High white cells = infection screen. |
| Coagulation profile (PT, PTT, INR) | How quickly blood clots | Abnormal values prompt review of medications and may delay surgery for correction. |
| Kidney function (Creatinine, BUN, eGFR) | How well kidneys clear waste | Anaesthesia drug dosing changes. Contrast imaging may be substituted. |
| Liver function (ALT, AST, ALP, Albumin) | Liver injury, drug metabolism, healing capacity | Drug choices change. Albumin under 3.5 g/dL signals nutritional optimisation needed. |
| Electrolytes (Na, K, Cl, Mg, Ca) | Heart rhythm and anaesthesia stability | Low potassium delays surgery for correction. Other imbalances corrected pre-induction. |
| Fasting glucose + HbA1c | Now and 3-month average blood sugar | HbA1c <8% is the elective surgery target (2025 ADA). Above 8 = optimisation window. |
| Viral screen (HBV, HCV, HIV) | OR safety and post-exposure planning | Operating room precautions adjusted; in some cases informs anaesthesia protocol. |
| 12-lead ECG | Heart electrical activity, rhythm, old infarcts | New abnormalities prompt cardiology review. |
| Chest X-ray (when indicated) | Lung disease, heart size, hidden infection | Smokers and patients over 50 routinely. Findings may trigger pulmonary consult. |
Why we test HbA1c for non-diabetic patients
HbA1c on the standard panel surprises some patients. They are not diabetic; why test it? Because up to 1 in 8 adults in Egypt has undiagnosed prediabetes or diabetes. Catching it before surgery lets us optimise wound healing and reduce infection risk. The 2025 ADA recommendation extends the <8% target to all elective surgery patients, not just diagnosed diabetics.
Dr. Khaled Ghalwash reads every test on the standard panel against the planned operation, not in isolation. A creatinine of 1.4 means one thing for an elective gallbladder and a different thing for a major bariatric procedure with hours of anaesthesia ahead. Context turns numbers into decisions.
Why ECG and chest X-ray for non-cardiac surgery
Anaesthesia stresses the heart and lungs regardless of which body part is being operated on. ECG screens for arrhythmias and old silent heart attacks. Chest X-ray screens for unsuspected lung disease, especially in smokers and patients over 50. The cost is small compared to discovering a problem mid-anaesthesia. The protocol is conservative on these specifically because the discovery time is the worst possible time.
Test validity windows
Most pre-op tests have a validity window after which they are repeated:
- CBC, coagulation, kidney, liver, electrolytes: 4 weeks for elective surgery.
- HbA1c: 8 weeks; longer if stable and well-controlled.
- Viral screen: 6 to 12 months for ongoing care; repeat closer to surgery if any exposure risk changed.
- ECG: 6 months for stable patients; repeat if any new symptom.
- Chest X-ray: 12 months for stable patients; sooner with new respiratory symptoms.
What to bring
Original printed reports of any tests done within the validity window, the disc with imaging files (not photos of the report), a complete medication list including injections and supplements, and a written list of any allergies with the actual reaction described. Dr. Khaled Ghalwash reads images himself in consultation, so the disc matters more than the radiologist's summary.
Frequently asked questions
What is the difference between a CBC and a metabolic panel?
CBC counts blood cells: red, white, platelets. It tells the surgeon about anemia, infection, and bleeding risk. The metabolic panel measures kidney, liver, and electrolytes. Different organs, different questions, both required before surgery.
Why HbA1c for non-diabetic patients?
HbA1c shows average blood sugar over 3 months. Up to 1 in 8 adults in Egypt has undiagnosed prediabetes or diabetes. Catching it before surgery lets us optimize healing and reduce wound infection risk. ADA 2025 recommends HbA1c under 8% before elective surgery for everyone.
Do I need to repeat tests I did recently?
If your tests are within validity windows, original results are kept. CBC, coagulation, and metabolic panel within 4 weeks are usually fine. ECG within 6 months is fine if no symptoms changed. Bring original printed reports to the consultation.
Why ECG and chest X-ray for non-cardiac surgery?
Anesthesia stresses the heart and lungs regardless of which body part is being operated on. ECG screens for arrhythmias and old silent heart attacks. Chest X-ray screens for unsuspected lung disease, especially in smokers and patients over 50. The cost is small compared to discovering a problem mid-anesthesia.
Schedule with Dr. Khaled Ghalwash and Dr. Mohamed Ghalwash
Book your pre-operative consultation. We send the test list before any tests are ordered, review every result with you, and confirm the operation date once your numbers are where they should be.
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