What Happens Before, During and After Surgery
This is 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, an adolescent or an adult have surgery, more information on preparations are performed. During the surgery the bodily functions of the patient is supported and monitored by the means already prepared before the surgery as such. After the surgery the supporting measures are disconnected in a particular sequence.
All of the measures are fundamentally the same for children and adults, but 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. All the measures are not 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 exactly the same way at where you have surgery or perhaps work.
Greatest variation could very well be to be found in the choice between general anesthesia and only regional or local anesthesia, specifically for children.
There will always be some initial preparations, which some often will need place in home before going to hospital.
For surgeries in the abdominal area the digestive tract often must be totally empty and clean. That is achieved by instructing the individual to stop eating and only continue drinking at least one day before surgery. The patient will also be instructed to take some laxative solution which will loosen all stomach content and stimulate the intestines to expel this content effectively during toilet visits.
All patients will be instructed to stop eating and drinking some hours before surgery, also whenever a total stomach cleanse isn’t necessary, in order to avoid content in the stomach ventricle that may be regurgitated and cause difficulty in breathing.
Once the patient arrives in hospital a nurse will receive him and he’ll be instructed to shift to some kind of hospital dressing, which will typically be a gown and underpants, or perhaps a sort of pajama.
If the intestines have to be totally clean, the individual will most likely also get an enema in hospital. This can be given as one or even more fillings of the colon through the anal opening with expulsion at the toilet, or it really is distributed by repeated flushes by way of a tube with the patient 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 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 ensure that the patient is fit for surgery, like hearing the center and lungs, palpating the stomach area, examining the throat and nose and asking about actual symptoms. The anesthetist could also ask the patient if he has 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 patient 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. Chirurg Zürich Many hospitals have however an insurance plan of using general anesthesia for most surgeries on adults and all surgeries on children. Some could have a general policy of local anesthesia for certain surgeries to help keep down cost. Some will ask the patient which kind of anesthesia he prefers plus some will switch to another sort of anesthesia than that of the policy if the patient demands it.
When the anesthetist have signaled green light for the surgery to take place, 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 as an injection through the anus.
The purpose of this medication is to make the individual calm and drowsy, to eliminate worries, to alleviate pain and hinder the individual from memorizing the preparations that follow. The repression of memory sometimes appears as the most important aspect by many medical professionals, but this repression won’t be totally effective so that blurred or confused memories can remain.
The patient, 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 into a preparatory room where in fact the induction of anesthesia takes place, or right into the operation room.
MEASURES PERFORMED BEFORE ANESTHESIA
Before anesthesia is set up the patient will be linked to several devices which will stay during surgery plus some time after.
The patient will receive 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 perhaps a leg to measure blood circulation pressure. He will also get yourself a syringe or perhaps a tube called intravenous line (IV) right into a blood vessel, typically a vein in the arm. A couple of 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 make certain all parts of the body work in a manner that allows the surgery to take place or even to detect abnormalities that want 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 frequently makes the patient 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 in to the rectum and continued with gas.
Once the patient is dormant, we will always get gas blended with a high concentration of oxygen for some while to ensure a good oxygen saturation in the blood.
By many surgeries the staff wants the individual to be totally paralyzed so that he does not move any body parts. Then the anesthetist or perhaps a helper will give a dose of medication through the IV line that paralyzes all muscles in your body, including the respiration, except the heart.
Then the anesthetist will start the mouth of the patient 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 help 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 in addition guides the laryngeal tube during insertion.