Doctor, when will I be able to drive after surgery?

Don't Get Behind the Wheel Too Soon After Surgery By Michael J. Smith, MD A common patient question involves when driving is safe following a surgical procedure or injury.  As a rule, the day of an outpatient surgical procedure, the patient should not drive.  Most surgery centers require an escort be present to take the patient home and document that the patient is not driving.  Studies have shown that a person usually has some motor deficit following general anesthesia for 24 hours following a procedure.  Driving should not be undertaken until at least this time. Some narcotics can remain in the body for extended time periods and most people should not return to driving until at least 24 hours after narcotic usage has stopped. Cast and Braces Any injury or surgery that requires a brace or cast that would interfere with the use of the hand or right foot would easily impair someone’s ability to drive safely.  The National Highway Transportation Safety Administration (NHTSA) advises that the use of the left foot and leg to use the accelerator and braking pedals is not a safe alternative for drivers that are unable to use their right leg due to casting.   The NHTSA also notes that drivers with a right leg cast should avoid driving until after the removal of the cast and until the mobility of the joint is adequate for safe driving. Knee Surgery Following left knee surgery, with use of an automatic transmission, driving would be permissible after the initial 24 postoperative hours.  For a right knee arthroscopy, a return to driving may take days to weeks until the patient is off narcotics and pain and swelling in the right knee has diminished. An ACL reconstruction requires a longer recovery before the pain and swelling have decreased and safe driver reaction times have returned.  Two studies examining brake reaction time, showed safe reaction times resuming following ACL surgery took  between 4-6 weeks.  Return to driving recommendations should also be individualized. Shoulder Surgery For shoulder surgeries, the usual advice to patients is not to return to driving until two hands can be placed on the wheel. Following a rotator cuff or labral repair, the usual postoperative physical therapy regimen is for passive range of motion only for the first four to six weeks.  Using the operative arm and shoulder to actively turn a vehicle especially around a corner could jeopardize the surgical repair. In summary, driving after a surgical procedure should not be done for at least 24 hours.  Any brace or cast that affects limb mobility could prevent safe driving, therefore patients should be advised not to drive accordingly.   REFERENCES Chung F, Kayumov L, Sinclair DR, Moller HJ, Shapiro CM. What is the driving performance of ambulatory surgical patients after general anesthesia? Anesthesiology. 2005.103:951– 6. Dalury DF, Tucker KK, Kelly TC. When can I drive? Brake response times after contemporary total knee arthroplasty. Clin Orthop Relat Res. 2011. 469(1): 82-86. Driver Fitness Medical Guidelines. September 2009. Gotlin RS, Sherman AL, Sierra N, Kelly M, Scott WN. Measurement of brake response time after right anterior cruciate ligament reconstruction. Arthoscopy. 2000.16(2):151-155. Hau R, Csongvay S, Bartlett J. Driving reaction time after right knee arthroscopy. Knee Surg Sports Traumatol Arthrosc. 2000. 8(2):89-92. Nguyen T, Hau R, Bartlett J. Driving reaction time before and after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc. 2000.8(4):226-230.