What Happens Before, During and After Surgery

This can be an account of everything that happens, or may happen, during and around a surgical intervention and sometimes also when complicated examinations are performed.

When a child, a teenager or an adult have surgery, a long list of preparations are performed. During the surgery the bodily processes of the patient is supported and monitored by the means already prepared prior to the surgery as such. Following the surgery the supporting measures are disconnected in a particular sequence.

All of the measures are essentially the same for children and adults, however the psychological preparations will differ for different age groups and the supporting measures will sometimes become more numerous for children.

The following is really a nearly complete listing of all measures undertaken by surgery and their typical sequence. Each of the measures aren’t necessarily present during every surgery and there’s also cultural differences in the routines from institution to institution and at diverse geographical regions. Therefore everything won’t necessarily happen in a similar way at the place where you have surgery or perhaps work.

Greatest variation could very well be found in the decision between general anesthesia and only regional or local anesthesia, specifically for children.

INITIAL PREPARATIONS

There will always be some initial preparations, which some often will take place in home before going to hospital.

For surgeries in the stomach area the digestive system often should be totally empty and clean. This is achieved by instructing the individual to stop eating and only keep on drinking a minumum of one day before surgery. The patient may also be instructed to take in some laxative solution that will loosen all stomach content and stimulate the intestines to expel the content effectively during toilet visits.

All patients will be instructed to avoid eating and drinking some hours before surgery, also when a total stomach cleanse isn’t necessary, in order to avoid content in the stomach ventricle that can be regurgitated and cause breathing problems.

Once the patient arrives in hospital a nurse will receive him and he will be instructed to shift to some kind of hospital dressing, which will typically be a gown and underpants, or a sort of pajama.

If the intestines have to be totally clean, the patient will often also get an enema in hospital. This can be given as one or more fillings of the colon through the anal opening with expulsion at the toilet, or it might be given by repeated flushes through a tube with the patient in laying position.

Then the nurse will take measures of vitals like temperature, blood circulation pressure and pulse rate. Especially children will most likely get yourself a plaster with numbing medication at sites where intravenous lines will undoubtedly be inserted at a later stage.

Then the patient and also his family members could have a talk to the anesthetist that explains particularities of the coming procedure and performs a further examination to make certain the patient is fit for surgery, like hearing the heart and lungs, palpating the stomach area, examining the throat and nose and asking about actual symptoms. The anesthetist may also ask the patient if he’s got certain wishes about the anesthesia and pain control.

The individual or his parents will often be asked to sign a consent for anesthesia and surgery. The legal requirements for explicit consent vary however between different societies. In a few societies consent is assumed if objections are not stated at the initiative of the individual or the parents.

Technically most surgeries, except surgeries in the breast and a few others can be carried out with the individual awake and only with regional or local anesthesia. Many hospitals have however a policy of using general anesthesia for some surgeries on adults and all surgeries on children. Some could have an over-all policy of local anesthesia for certain surgeries to keep down cost. Chirurg Zürich Some will ask the patient which kind of anesthesia he prefers plus some will switch to some other sort of anesthesia than that of the policy if the patient demands it.

Once the anesthetist have signaled green light for the surgery to occur, the nurse gives the individual a premedication, typically a kind of benzodiazepine like midazolam (versed). The premedication is usually administered as a fluid to drink. Children will sometimes obtain it as drops in the nose or as an injection through the anus.

The objective of this medication would be to make the individual calm and drowsy, to take away worries, to ease pain and hinder the individual from memorizing the preparations that follow. The repression of memory sometimes appears as the main aspect by many doctors, but this repression won’t be totally effective in order that blurred or confused memories can remain.

The individual, and especially children, will most likely get funny feelings by this premedication and will often say and do strange and funny things before he is so drowsy he calms totally down. Then the patient is wheeled right into a preparatory room where in fact the induction of anesthesia takes place, or directly into the operation room.

MEASURES PERFORMED RIGHT BEFORE ANESTHESIA

Before anesthesia is set up the patient will be linked to several devices that will stay during surgery plus some time after.

The patient will receive a sensor at a finger tip or at a toe connected to a unit that may monitor the oxygen saturation in the blood (pulse oximeter) and a cuff around an arm or a leg to measure blood pressure. He will also get a syringe or perhaps a tube called intravenous line (IV) right into a blood vessel, typically a vein in the arm. Several electrodes with wires may also be placed at the chest or the shoulders to monitor his heart activity.

Before proceeding the anesthetist will once again check all of the vitals of the individual to make sure that all parts of the body work in a manner that allows the surgery to occur or to detect abnormalities that require special measures during surgery.

Right before the definite anesthesia the anesthetist may provides patient a new dose of sedative medication, often propofol, through the IV line. This dose gives further relaxation, depresses memory, and often makes the individual totally unconscious already at this stage.

INDUCTION OF GENERAL ANESTHESIA

The anesthetist will start the general anesthesia giving gas blended with oxygen by way of a mask. It can as an alternative be started with further medication through the intravenous syringe or through drippings into the rectum and then continued with gas.

Once the patient is dormant, we will always get gas blended with a high concentration of oxygen for a few while to ensure an excellent oxygen saturation in the blood.

By many surgeries the staff wants the patient to be totally paralyzed in order that he does not move any body parts. Then the anesthetist or a helper will give a dose of medication through the IV line that paralyzes all muscles in your body, like the respiration, except the center.

Then your anesthetist will open up the mouth of the individual and insert a laryngeal tube through his mouth and past the vocal cords. There exists a cuff around the end of the laryngeal tube that’s inflated to keep it in place. The anesthetist will aid the insertion with a laryngoscope, an instrument with a probe that is inserted down the trout that allows him to look into the airways and also guides the laryngeal tube during insertion.