Rapid recovery after joint replacement surgery - Dr Shreedhar Archik

Dr Shreedhar Archik - Orthopedic Surgeon Mumbai Dadar

“Doctor, your staff made my grandmother have her lunch immediately after surgery!”

Jayesh and RakeshZaveri sat in front of me in my clinic and complained. They were surprised as well as a bit unhappy. It is common feeling amongst us that a patient after an “operation” should be starving.

Jayesh and Rakesh’s grandmother was scheduled for a knee replacement surgery at 8 am in the morning. She had been kept fasting from 12 midnight. Jayesh was by her side when she asked for a glass of water at 530 am. He refused to give it to her as he had understood the instructions clearly from the duty doctor about keeping her “nil by mouth”. His grandmother felt a bit thirsty and kept nagging him. He was surprised when the duty nurse allowed him half a glass of water without batting an eyelid. He looked at her as if she was from another planet. He mentally made a note of complaining about her.

In reality we doctors allow our patients clear liquids up to 2 hours before scheduled surgery. Water or clear juice like “aapey” is allowed. We follow a protocol of rapid recovery and one of the features is keeping patients well nourished. We did her surgery under spinal anesthesia which meant she was fully awake during the surgery. After the surgery got over she was administered a nerve block to help her recover from surgery without pain. She had no catheter (tube) in her bladder to pass urine because we had planned to make her walk in the evening. She had a glass of water immediately after the surgery in the recovery room. She wanted “tea” which was promised once she returned to the ward.

We finished her surgery by 10am and she was back in her room at 12 noon. She had a nice lunch and then walked to the toilet at 230 pm. It is now proved that by not keeping the patients starving we help their recovery. Only patients undergoing a general anesthesia are kept starving 4 to 6 hours after surgery. In orthopedic surgeries most of the surgeries areon limbs and hence we can avoid general anesthesia.

Noticing their grandmother having lunch was something amazing as well as unusual for Jayesh and Rakesh and they came to find out more about this “strange” phenomenon.

At the age of 76 Urmilaben went home on the 3rd post-operative day, walking and able to climb stairs, after a knee replacement.

This is rapid recovery after a surgery

Take home message:

One need not be starving unnecessarily for surgery. 6 hours is enough and clear liquids are allowed up to 2 hours before surgery.

Surgery under nerve blocks and spinal are always better tolerated than general anesthesia

One can eat and drink immediately after the surgery is over.

Try and get going i.e. walk as early as possible and you would recover quickly.

Ask your doctor if you would be in the “rapid recovery” group.
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