Evaluation of patients' perception of safety to drive after outpatient, minimally invasive procedures of the hand
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CASE REPORTS
Evaluation of patients' perception of safety to drive after outpatient, minimally invasive procedures of the hand Warren C. Hammert & Ronald Gonzalez & John C. Elfar
Published online: 30 August 2012 # American Association for Hand Surgery 2012
Patients frequently ask if they can drive after minimally invasive surgery of the hand under local anesthesia. Evidence does not exist to provide a definitive answer to this question. Many physicians are unclear on the patient's safety and the patient's perception of this decision. The purpose of this study is to evaluate the patient's perception of safety when driving immediately after hand surgery under local anesthesia without sedation. We sought to assess the factors affecting the decision to drive after such surgery and the timing of returning to driving. We also investigated whether patients have had any difficulties, specifically motor vehicle collisions or summons issued for traffic violations.
men. The average age of the patients was 58 (range 20–89) years. There were 139 procedures performed on the 139 patients by four attending hand surgeons: 69 (49.6 %) carpal tunnel releases, 31(22.3 %) A1 pulley releases, 18 (12.9 %) mucous cyst excisions, 10 (7.1 %) ganglion cyst excisions, 6 (4.3 %) first dorsal compartment releases, 3 (2.2 %) foreign body removals, and 2 (1.4 %) amputations. All procedures were performed with local anesthesia infiltrated into the surgical field. Patients were asked a series of questions and answers were recorded on a Microsoft Excel spreadsheet (Table 1). Variables of interest for study participants were summarized using appropriate descriptive statistics. Alternate questions were used for patients that had not driven home after their surgery (Table 2).
Materials and Methods
Results
After obtaining approval from the institutional review board, we identified 428 patients who had hand surgery under local anesthesia without sedation over a 5-month period performed by four surgeons. Patients were identified through a database of outpatient procedures. A chart review was preformed to identify the age of the patient, gender, and procedure type. Patients were then contacted to complete a telephone interview. Three attempts were made to reach each patient and messages were left for those we were unable to contact. No attempts were made at mailing the questionnaire to remain within the study time frame. Of the 428 patients identified, 139 were available and completed the questionnaire. The cohort included 78 women and 61
Of the 428 patients indentified who had hand surgery under local anesthesia, 139 completed the questionnaire. There was no statistically significant difference in the results of patients who drove immediately after surgery or those who did not between surgeons, procedure, or technique (Table 3). Of those 139 patients who underwent hand procedures under local anesthesia, 69 (49.6 %) operated a vehicle immediately after surgery. One hundred thirty-one patients drove an automatic transmission car, while eight patients
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