Small Changes Pre-Surgery Equal Big Gains After

It is the little things that make the difference—such as giving patients for hip or knee replacement surgery pain killers before the surgery—instead of after. Galway, Ireland, surgeon Derek Bennett, M.D. has his patients on their feet as soon as two hours after surgery thanks to a program he first learned about from doctors in Denmark.

The program does not involve any dramatic change in the surgical procedure but is, instead, a series of small changes that Bennett calls his” Rapid Recovery” program. He administers painkillers to patients before their surgery, keeps them warm to minimize inflammation and gives them a sugar drink to counteract the negative effects of fasting before surgery.

“In the past, if you had your knee or your hip replaced you would typically be given painkillers like morphine afterwards, to try and control your pain, ” Bennett said. “With Rapid Recovery, the attitude is, ‘Well, we know you’re going to have pain, so we’re going to give you some painkillers pre-emptively before you have the surgery’.” He claims that by giving the patients pain relief prior to the surgery they can avoid post-operative drowsiness and nausea and be able to begin the rehabilitation process almost immediately. Bennett’s program also teaches patients how to use and become comfortable on crutches before their surgery. It’s a simple idea, says Bennett, but one that greatly enhances the patients’ post-operative experience. “The hardest time to learn how to use crutches is just after you’ve had major surgery.”

“We’ll often start them exercising in the recovery room about 20 minutes after the operation and usually get them up walking about two hours after they have had their hip or knee replacement, ” he said.

Bennett claims the program is popular with the hospital. Among the benefits are reduced patient pain, reduced hospital stays, shorter rehabilitation periods and a decrease in the need for blood transfusions. “The patients love it because they have less pain and they’re in the hospital for less time and they’re mobile much quicker. The staff looking after them loves it because they’re much more independent and there’s less caring to be done for them. The hospital managers love it because patients are spending less time in the hospital and therefore costing less money, ” explained Bennett.