Section 12: Effects of Anesthesia and Surgery

1. Abdominal, back, and chest surgery

2. Anesthesia

  1. General
  2. Local
  3. Epidural
  4. Spinal

3. Neurosurgery

4. Orthopedic surgery

Physicians should be alert to peri- and post-operative risk factors that may affect the patient’s cognitive function post-surgery, placing the patient at risk for impaired driving. Risk factors include:

If the physician is concerned that residual visual, cognitive, or motor deficits following the surgery may impair the patient’s driving performance, referral to a driver rehabilitation specialist for a driver evaluation (including on-road assessment) is highly recommended.

Physicians should counsel patients who undergo surgery—both inpatient and outpatient—not to drive themselves home following the procedure. Although they may feel capable of driving, their driving skills may be affected by pain, physical restrictions, anesthesia, and/or analgesics. (For specific recommendations regarding musculoskeletal restrictions and narcotic analgesics, please see Sections 8 and 5, respectively.) Physicians should also remind patients to wear their safety belts properly (over the shoulder, rather than under the arm) and position themselves at least 10 inches from the vehicle airbags whenever they are in a vehicle as a driver or passenger. The patient should sit in the vehicle seat that is most likely to accommodate these needs.

In counseling patients about their return to driving after a surgical procedure, it is useful for the physician to ask whether the patient’s car has power steering and automatic transmission. Physicians can tailor their driving advice accordingly.

As patients resume driving, they should be counseled to assess their comfort level in familiar, traffic-free areas before driving in heavy traffic. If the patient feels uncomfortable driving in certain situations, he/she should avoid these situations until his/her confidence level has returned. A patient should never resume driving until he/she feels ready to do so.


Section 12: Effects of Anesthesia and Surgery


Abdominal, back and chest surgery The patient may resume driving after demonstrating the necessary strength and range of motion for driving.

See Section 2 for recommendations on surgeries involving median sternotomy.

See Section 10 for recommendations on renal transplant.

Anesthesia Because anesthetic agents and adjunctive compounds (such as benzodiazepenes) may be administered in combination, the patient should not resume driving until the motor and cognitive effects from all anesthetic agents have subsided.

General
Both the surgeon and anesthesiologist should advise patients against driving for at least 24 hours after a general anesthetic has been administered. Longer periods of driving cessation may be recommended depending on the procedure performed and the presence of complications.

Local
If the anesthetized region is necessary for driving tasks, the patient should not drive until he/she has recovered full strength and sensation (barring pain).

Epidural
The patient may resume driving after recovering full strength and sensation (barring pain) in the affected areas.

Spinal
The patient may resume driving after recovering full strength and sensation (barring pain) in the affected areas.

Neurosurgery See recommendations for post intracranial surgery in Section 3.

Orthopedic surgery See recommendations for orthopedic procedures/surgeries in Section 8.



Table of Contents