Here's a paper which seems pragmatic. Vallier and her colleagues from MetroHealth Medical Center (US spelling) in Cleveland, Ohio - which is a big league level 1 trauma centre - looked at more than 1400 cases from a retrospective database.
My take on their findings is that an absolute figure for lactate and 'safe' operating is not the issue. A range of 2 to 4 mmol/l is OK, and it's the trend that matters. So near patient lactate testing is very handy, and most things can wait till the morning for major surgery, as opposed to essential damage control.
Your anaesthetist may or may not be aware of this stuff, so you can educate them.
I'll put up a sensible 'lactate protocol' in due course.
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