Time progression from the patient's operating room entrance to incision: factors affecting anesthetic setup and surgical preparation times.
OBJECTIVE
Owing to recent advances in surgical technology, substantial time is required for preparing surgical equipment before incision. The purpose of this study was to demonstrate the time progression from a patient's operating room entrance to incision and to evaluate the duration of each anesthetic procedure and surgical preparation.


METHODS
We marked the following seven points on the anesthetic chart: (1) entrance; (2) i.v. line placement; (3) preoxygenation; (4) intubation; (5) completion of patient positioning (Anesth-Set); (6) applying antiseptic solution; and (7) incision. Afterward, we analyzed the event time periods according to anesthetic procedure, patient position, surgical service, and surgical procedure (such as the utilization of endoscopy, navigation systems, and sentinel lymph node biopsy).


RESULTS
On average, it took approximately 3 min to start i.v. placement, 7 min until preoxygenation, 15 min until intubation, and 30 min until Anesth-Set. Epidural, arterial, and central venous catheterization required 15, 9, and 13 min, respectively. It took 20 min from Anesth-Set to incision, on average; 22, 4, and 5 min were required to prepare the navigation system, endoscope, and sentinel lymph node biopsy, respectively. In total, it took an average of 49.8 +/- 17.1 min from entrance to incision, which was significantly longer (30.4 +/- 8.8 min) than it took in 1985-1986.


CONCLUSIONS
The mean time taken from the patient's operating room entrance to incision is now significantly longer than before. This may be attributed, at least in part, to the preparation of equipment associated with new surgical technologies.
Sasano
Nobuko
N
Department of Anesthesiology and Medical Crisis Management, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8622, Japan.
Morita
Masato
M
Sugiura
Takeshi
T
Sasano
Hiroshi
H
Tsuda
Takako
T
Katsuya
Hirotada
H
D000768:Anesthesia, General; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D007442:Intubation, Intratracheal; D009873:Operating Rooms / Q000458:organization & administration*; D019990:Perioperative Care / Q000379:methods*; D011187:Posture; D011229:Preanesthetic Medication; D012189:Retrospective Studies; D013514:Surgical Procedures, Operative; D013997:Time Factors
D000891:Anti-Infective Agents, Local