The minimum acceptable hemoglobin level for elective surgery is generally considered to be 7 g/dL. At this threshold, patients usually have adequate oxygen-carrying capacity to tolerate the physiological stress of surgery without increased risk of tissue hypoxia. Lower hemoglobin levels (<7 g/dL) are associated with higher perioperative morbidity and mortality due to insufficient oxygen delivery. Thus, optimizing hemoglobin above 7 g/dL helps ensure safe anesthesia and surgical outcomes. Transfusion decisions are individualized but 7 g/dL serves as a widely accepted trigger in stable patients undergoing elective procedures.

Reference: Miller’s Anesthesia, 9th Edition.