Morning: Best Time for Surgery, Fewer Anesthesia Complications
Researchers at the Duke University Health Simulation and Patient Safety Center have concluded that patients anesthetized for surgery in the afternoon are more likely to develop anesthesia-related complications than those undergoing morning surgery.
According to a recent WebMD article, the most common time for problems is the 3 p.m. to 4 p.m. slot. The researchers studied 90,000 surgeries over a four year span and divided complications into three categories:
- Error, to include administration of wrong medications or wrong doses,
- Harm, to include prolonged sedation, wound infections, and nausea and vomiting after surgery, and
- Other adverse events, such as pain management.
The most significant changes came in the “other” category, which showed a 3% increase in complications with pain management, nausea, and vomiting after surgery.
Researchers speculate that there may be two causes for the increase. First, they cite the shift changes that occur at the hospital between 3 p.m. and 6 p.m. Second, a circadian low-point that occurs at that point in the day may play a role. They say that the circadian low-point, coupled with simple end of the day fatigue may be a significant cause of the problems.
The Duke study was recently published in Quality and Safety in Health Care. According to Melanie Wright, a human factors specialist at Duke University Human Simulation and Patient Safety Center, "identifying the specific periods when problems are most likely to occur is an important step in the overall process of making surgery safer and ensuring that patients have a good experience."