Expert: JM Starkman, MD - 5/28/2009

Question
     Last month I had Laparoscopic gallbladder surgery with general anesthetic. I expected to see my Surgeon in pre-op, but when he didn't show the nurses assured me I would see him in the OR. I was wheeled headfirst into the OR and positioned on the table. Then suddenly with out any introduction the anesthesiologist starts the anesthesia, surprised and upset I try to object, but I succumb to the drugs. I had a very difficult time waking up in recovery, about 2.5 hours. This recovery was my far the worst of my six surgeries.
     Did my being surprised and upset during the induction contribute to the poor recovery?
     Also according to my surgical records the surgery started twenty minutes after the induction of the anesthesia. Why the delay?

Thank you  

Answer
No, I do not think your surprise and upset contributed to the poor recovery. You did not mention how long the surgical procedure took to do once the surgeon got started--longer surgery time, for one thing,  could mean a greater exposure to whatever component of the anesthetic seemed to prolong your recovery.  There might be many explanations for the phenomenon you described, though.

Twenty minutes from induction to incision is really quite impressive, not overly long at all:  after induction of the anesthetic which itself may take 5-10 minutes or longer depending on many factors, the O.R. staff must not only properly wash, scrub {"prep") you, but drape and re-verify everything that's to happen in the OR during your case/operation.....no problem here.

After 2.5 hours in recovery you seem to have otherwise done well, and this tells me that this OR setting was willing to keep you in recovery as long as it needed to in order to assure your proper recovery from surgery and anesthesia. The OR in which you had your operation most likely was more concerned with 'efficiency' and "hurrying-up" rather than simply taking the time to allow you to first speak with your surgeon for peace of mind. And an awful lot of ORs and surgeons conduct themselves in this fashion. That recovery did not feel this type of production pressure to 'get you out as soon as an hour was up' (I've seen that too with accompanying disaster) is a thumbs-up to the recovery nursing management.

I don't think there is much to be gained by continuing to review your records of this surgery and anessthetic.