In a hip replacement operation, how long does it take for the patient to go under before the surgeon can start and how long is the reversal time after the operation before being moved out of theatre
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First Helper User Profile Gaelic
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replied May 24th, 2011
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satelite,

That is very patient dependent and also at the discretion of the anestheologist. Depending upon the patient's medical condition and anxiety level, the anestheologist may place the patient under very quickly, or he/she may have to take some time to make sure the patient is stable.

Reversal can be very short, with almost immediate awareness, or the anestheologist can keep the patient under sedation until the patient reaches the recovery room.

If you have concerns about your anesthesia, speak with your anesthesia team before the surgery. Tell them exactly how sedated you want to be. Some patients want to be aware of everything that is going on, if possible. Others would prefer to begin sedation in the pre-op holding and have amnesia for the whole procedure.

Just speak up, and tell them how you would prefer the experience to be.

Good luck.
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replied May 24th, 2011
Thanks for the reply, sorry if the question was a bit vague. What I,m trying to work out is the operation time of an actual operation that was carried out. The only info I have is "First observation 16:31" - "Last observation 17:15" from the anesthetist notes. I,ve read the "first" is when the mask is first placed over the mouth and the "last" is end of reversal A minimum time will do so I can work out the Maximum time the surgeon had.
Thnx
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replied May 24th, 2011
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satelite,

Every anesthesia sheet is different, but they all usually have the same information. There will be a time noted as to when the patient becomes the responsibility of the anestheologist. This is usually in the OR, when the leads are being placed and oxygen is being administered. (There is also a note as to any pre-op meds given in the holding area.) This time does not end until the patient is transferred to the providers in the recovery room.

There will be vital signs noted every few minutes. Somewhere there will be a time at which specific medicines are given (ie induction meds, inhalation meds, IV meds, pain meds, reversal agents, etc). Usually there will also be a time given at which the nurse is allow to start to prep and drape the operative area. There will be a note as to when the tourniquet is put up and at what pressure. There will also be a "cut time", which is when the first incision is made. The time when the tourniquet is deflated is noted. Another time for the surgeon will be when the dressing is completed and the operation is over. The anestheologist may start the reversal when the incision is being closed, so that the patient can be transferred to the recovery room as soon as possible after the dressing is complete. So, you really have to know the anestheologist's shorthand.

In a routine THR, that goes smoothly, without any hitches, can be done in about 30 to 40 minutes of surgical time. Now, that's with an experienced surgeon and a well coordinated team. You also have to realize that the anesthesia time and surgical time do overlap, they are not mutually exclusive. In an operative report, there is usually given the start and end times of the procedure, as well as how long the tourniquet was up. The op report is dictated by the surgeon, and is separate from the anesthesia sheet.

If you want to know specific information about your procedure, ask your surgical team.
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replied May 24th, 2011
Its a bit hard to ask the surgeon as we are suing him for malpractice. The only info our solicitor has is that I have quoted above. From what I have read 44 minutes seems to short to do the job correctly. I would rate the surgoen moderate in his skill level from reading his history and position he holds. We feel he has not re-attached the muscle properly if at all.
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replied May 24th, 2011
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satelite,

You should have access to all of the medical records. Look at the Op Report, the one dictated by the surgeon, as it should be the easiest to read. Every hospital has its own requirements, but most op reports will have a minimum of start-stop times, tourniquet time (which is very close to the actual overall surgical time), and other info (procedure performed, surgeons, anesthesia, specimen, antibiotics, implants, complications, and a narrative of the procedure).

Surgeons who do less than 20 total joints a year, usually take about 60 to 90 minutes for a procedure. Those done in training facilities of course will take longer. But, for a fellowship trained total joint surgeon, who does 6 to 8 joints a week, working in a private facility where he/she has to best equipment and staff, 40 minutes is actually a very reasonable time.

Now this is for a routine THR. Where there are no problems and the procedure goes slick as snot, with everything falling into place easily. I have seen a total hip put in by a Mayo Clinic total joint specialist in 20 minutes, done beautifully. I have seen total hips that took 2 hours, which were also done beautifully. But, there is also the reverse. Time is not always a good predictor of the quality of the workmanship.

I wish you the best for the future.
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