A complex, high-risk, nonemergent surgical procedure (revision thoracic-sacral spinal fusion, estimated duration 5 hours) was completed on a weekday during late night hours by surgery and anesthesiology physicians who were otherwise on a daytime work schedule in a tertiary academic hospital. The patient entered the OR at 6:15 p.m. (incision at 7:30 p.m.) and left the OR at 2:20 a.m. and was discharged from the PACU at 4:30 a.m. A second peripheral I.V., right IJ CVC, and radial arterial line were placed after induction. Until about 9:30 p.m. the staff anesthesiologist was also medically directing three additional major surgical cases; the final concurrent medically directed case ended at approximately midnight. All concurrent cases were also scheduled surgeries and were not emergent. No other anesthesiologists were available to assist with the care of these patients and no other general ORs were operating.
Nearly every anesthesiologist will relate with the reporter...
