H. CALHOUNKARENMDB. KUPPERSMITHRONALDMD
Hartnick and Ruben have done an excellent job reviewing the controversial topic of coagulation studies prior to tonsillectomy. In my community, the surgeons seem to be about equally divided between those who always obtain preoperative PTs and PTTs and those who obtain preoperative studies in only selected patients as indicated by history. I personally order no laboratory studies on a routine basis for these patients, but I completely understand why my partners and colleagues do. I think all of us would like to think we are doing everything possible to prevent the life-threatening complication of postoperative hemorrhage. If I thought that a PT, PTT, and/or BT would help predict and ultimately avoid this complication, I would happily accept the additional discomfort and cost (I say "I" would; the insurance carrier might not).
Nowlin JH. Coagulation Studies Prior to TonsillectomyAn Unsettled and Unsettling Issue. Arch Otolaryngol Head Neck Surg. 2000;126(5):687. doi:10.1001/archotol.126.5.687