title: What is the driving performance of ambulatory surgical patients after general anesthesia?
abstract: BACKGROUND
  Ambulatory surgical patients are advised to refrain from driving for 24 h postoperatively. However, currently there is no strong evidence to show that driving skills and alertness have resumed in patients by 24 h after general anesthesia. The purpose of this study was to determine whether impaired driver alertness had been restored to normal by 2 and 24 h after general anesthesia in patients who underwent ambulatory surgery.
  
  
  METHODS
  Twenty patients who underwent left knee arthroscopic surgery were studied. Their driving simulation performance, electroencephalographically verified parameters of sleepiness, subjective assessment of sleepiness, fatigue, alertness, and pain were measured preoperatively and 2 and 24 h postoperatively. The same measurements were performed in a matched control group of 20 healthy individuals.
  
  
  RESULTS
  Preoperatively, patients had significantly higher attention lapses and lower alertness levels versus normal controls. Significantly impaired driving skills and alertness, including longer reaction time, higher occurrence of attention lapses, and microsleep intrusions, were found 2 h postoperatively versus preoperatively. No significantly differences were found in any driving performance parameters or electroencephalographically verified parameters 24 h postoperatively versus preoperatively.
  
  
  CONCLUSIONS
  Patients showed lower alertness levels and impaired driving skills preoperatively and 2 h postoperatively. Based on driving simulation performance and subjective assessments, patients are safe to drive 24 h after general anesthesia.
authors.affiliation: Department of Anesthesia, Toronto Western Hospital, University of Toronto, Ontario, Canada. frances.chung@uhn.on.ca
authors.forename: Frances
authors.initials: F
authors.lastname: Chung
authors.forename: Leonid
authors.initials: L
authors.lastname: Kayumov
authors.forename: David R
authors.initials: DR
authors.lastname: Sinclair
authors.forename: Reginald
authors.initials: R
authors.lastname: Edward
authors.forename: Henry J
authors.initials: HJ
authors.lastname: Moller
authors.forename: Colin M
authors.initials: CM
authors.lastname: Shapiro
mesh_terms: D000759:Adjuvants, Anesthesia; D000328:Adult; D000556:Ambulatory Surgical Procedures; D000768:Anesthesia, General; D018686:Anesthetics, Intravenous; D001288:Attention / Q000187:drug effects; D001334:Automobile Driving / Q000523:psychology*; D002940:Circadian Rhythm / Q000187:drug effects; D003198:Computer Simulation; D004569:Electroencephalography / Q000187:drug effects; D005221:Fatigue / Q000523:psychology; D005260:Female; D005283:Fentanyl; D006801:Humans; D008297:Male; D008874:Midazolam; D009609:Nitrous Oxide; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis; D015742:Propofol; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000187:drug effects*
chemical_list: D000759:Adjuvants, Anesthesia; D018686:Anesthetics, Intravenous; D009609:Nitrous Oxide; D008874:Midazolam; D005283:Fentanyl; D015742:Propofol