What Happens Before, After and during Surgery

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

When a child, an adolescent or a grown-up have surgery, a long list of preparations are performed. During the surgery the bodily functions of the individual 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 report on all measures undertaken by surgery and their typical sequence. All of the measures aren’t necessarily present during every surgery and there are also cultural differences in the routines from institution to institution and at diverse geographical regions. Therefore everything will not necessarily happen in a similar way at the place where you have surgery or perhaps work.

Greatest variation could very well be to 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, of which some often will take place in home before going to hospital.

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

All patients will undoubtedly be instructed to stop 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, that may typically be considered a gown and underpants, or perhaps a sort of pajama.

If the intestines must be totally clean, the individual will most likely 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 individual in laying position.

Then the nurse will need measures of vitals like temperature, blood 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 in addition his family members will have a talk with 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 abdominal area, examining the throat and nose and asking about actual symptoms. The anesthetist may also ask the individual if he’s got certain wishes about the anesthesia and pain control.

The individual or his parents may also be asked to sign a consent for anesthesia and surgery. The legal requirements for explicit consent vary however between different societies. In some societies consent is assumed if objections aren’t stated at the initiative of the individual or the parents.

Technically most surgeries, except surgeries in the breast and a few others can be performed with the individual awake and only with regional or local anesthesia. Many hospitals have however a policy of using general anesthesia for most 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. Some will ask the patient which kind of anesthesia he prefers plus some will switch to some other kind 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 will give the patient a premedication, typically a type of benzodiazepine like midazolam (versed). The premedication is usually administered as a fluid to drink. Children will sometimes get it as drops in the nose or being an injection through the anus.

The objective of this medication would be to make the individual calm and drowsy, to eliminate worries, to ease pain and hinder the individual from memorizing the preparations that follow. The repression of memory sometimes appears as the most crucial aspect by many medical professionals, 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 can often say and do strange and funny things before he is so drowsy that he calms totally down. Then the patient is wheeled into a preparatory room where the induction of anesthesia takes place, or directly into the operation room.

MEASURES PERFORMED BEFORE ANESTHESIA

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

The patient will get a sensor at a finger tip or at a toe linked to a unit which will 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 a tube called intravenous line (IV) right into a blood vessel, typically a vein in the arm. Several electrodes with wires are also placed at the chest or the shoulders to monitor his heart activity.

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

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

INDUCTION OF GENERAL ANESTHESIA

The anesthetist will start the general anesthesia by giving gas blended with oxygen through a mask. It can alternatively be started with further medication through the intravenous syringe or through drippings in to the rectum and then continued with gas.

After the patient is dormant, we shall always get gas blended with a high concentration of oxygen for a few while to ensure a good oxygen saturation in the blood.

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

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