Time of Surgery and Anesthesia Risk

The bottom line is that surgery in the morning has less perioperative complications than in late afternoon.

Patients who undergo surgery late in the afternoon are more likely to experience unexpected adverse events related to their anesthesia than are patients whose operations begin in the morning, a new analysis by Duke University Medical Center researchers suggests.
In the more than 90,000 surgeries analyzed, only a small percentage of the adverse events reported actually caused harm to the patients, the researchers said. The vast majority of events involved such serious though lesser problems as those related to pain management requiring additional attention to patients’ pain and postoperative nausea and vomiting.
“This is one of the first studies to show that there is a difference in patient outcomes depending on the start time of surgery,” said Melanie Wright, Ph.D., a human factors specialist in the Duke University Human Simulation and Patient Safety Center. Human factors specialists study how people behave physically and psychologically in different environments. Previous studies, she said, have examined the effects on patient outcomes of such factors as fatigue, sleep deprivation and circadian rhythms among health care workers.
In addition to spotting problems related to anesthesia, Wright and her colleagues also found that surgery patients experienced a significant increase in “administrative delays” during late afternoon, which might contribute to the increase in adverse events that occur during this time. The delays included waiting for laboratory test results, doctors running late, transporters not being available to move patients and rooms not being ready on time.

Link to the story at Duke University Medical Center…