Why is it necessary to get up after a 2-hour surgery to avoid blood cloths, but lying in bed for 8 hours + sitting still for 8 hours at work is okay?

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I was looking at a surgery I am considering. It said that to avoid blood cloths (i think it said in the legs ) they had to get me on the feet fast after. Why is it like that when I can lie in bed all night? Im assuming it is because im “asleep” under the surgery?

(English isn’t my first language, I don’t know the word for that thing they put in you to make you alive but not awake during surgeries)

If it is relevant, it is for a breast lift. But would it be the same case for most surgeries? And then what about leg surgeries where you can’t stand?

Thank you!

In: Biology

When you’re opened, your blood is exposed to the air and can start clotting. If a clot moves to a thin enough vein then it can block the flow completely and cause severe issues. These thinner veins can be found more in the extremities of your legs/feet. Walking around is kind of like shaking a bottle of ketchup to help liquefy it and to help breakup any small clots before they become a problem

Because sleeping =/= unconscious/anaesthetised

You fidget and move about in your sleep, especially if you lie in a funny position/squash a limb. You will move the affected body part without waking. If you fidget during surgery the anaesthetist gives you more drugs to keep you sedated.

Anaesthetics are a cocktail of drugs including strong muscle relaxants. Your pretty much totally immobilised, not the same as sitting still/sleeping

Edit to add: for leg surgery the patient is still encouraged to sit up and move about with crutches or a wheelchair. Other things you need to do after day surgery is have something to drink, then eat and go to the toilet. If you can do those things without a problem (being slower or using an aid is not a problem) then you can safely be discharged home

Your heart pumps blood around the body……………………. is kind of false. Your heart pumps blood around the arteries in your body. After this the blood enters the venous system (veins). This blood is not pumped around the body by the heart. Instead, it is moved through the veins via muscular contractions.

Due to gravity blood will pool in your legs. If you don’t move your legs around this blood will sit in your legs. Blood which isn’t circulating is at a higher risk of clotting.

Depending on the circumstances after surgery they may even give you anticoagulants to help prevent clots from forming. They may do this if the type of surgery has a higher risk of blood clots forming and/or if you have certain predispositions to developing clots.

I’ve had surgery. I’ve had a blood clot in my leg. I’ve had a pulmonary embolism (blood clot in the lung).

All of the above answers are true (you move in your sleep, etc).

But the postoperative state is also associated with inflammation and activation of the clotting cascade (which is physiologic and helpful in your recovery). But combined with at least a degree of hypercoagulability and endothelial dysfunction, venous stasis is dangerous.

Look up Virchow’s triad for further info.

Blood clots are caused by three things (this is called Virchow’s triad):

1. Venous stasis: if your blood isn’t moving, it’s more likely to clot. If you’re anesthetized for surgery you move less than if you’re sleeping naturally, and if you’re tired, in pain, or sedated to any degree after surgery you may move less than you would normally unless pushed to move around.
2. Hypercoagulability: surgery is a major stressor on the body and it results in a lot of metabolic changes as well as a pro-inflammatory / pro-coagulability response. So basically, among other changes, your body responds to surgery by making blood clotting happen more easily.
3. Endothelial damage: undamaged blood vessels act to prevent clotting, but when they are damaged they help start clots. Blood vessels can of course be damaged at the site of surgery, but blood vessel damage can also be caused from being under general anesthesia because it can cause veins to relax too much and become distended.

As you can see, there are several ways surgery makes clots more likely, making moving around afterwards (and frequently the use of anti-clotting medications) more important. The anti-clotting medications can of course be used after leg surgeries, but still patients are usually pushed to get up and move (in safe ways) as soon as possible after leg surgeries. Early mobilization is very big in hip and knee replacements.