What Happens Before, After and during Surgery
This is an account of everything that happens, or you can do, during and around a surgical intervention and sometimes also when complicated examinations are performed.
When a child, a teenager or a grown-up have surgery, more information on preparations are performed. During the surgery the bodily processes of the individual is supported and monitored by the means already prepared prior to the surgery as such. After the surgery the supporting measures are disconnected in a specific sequence.
All of the measures are fundamentally the same for children and adults, but the psychological preparations will differ for different age ranges and the supporting measures will sometimes be 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 are 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 to be found in the decision between general anesthesia and only regional or local anesthesia, specifically for children.
There will be some initial preparations, of which some often will take place in home before going to hospital.
For surgeries in the stomach area the digestive tract often must be totally empty and clean. This is achieved by instructing the individual to avoid eating and only keep on drinking at least one day before surgery. The patient may 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 is not necessary, to avoid content in the stomach ventricle that could be regurgitated and cause difficulty in breathing.
When the patient arrives in hospital a nurse will receive him and he’ll be instructed to shift for 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 is often given as one or more fillings of the colon through the anal opening with expulsion at the bathroom ., or it could be distributed by repeated flushes by way of a tube with the individual in laying position.
Then the nurse will need 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 in addition his family members will have a talk to the anesthetist that explains particularities of the coming procedure and performs a further examination to make certain the individual is fit for surgery, like hearing the center 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 has certain wishes concerning 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 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 carried out with the individual awake and only with regional or local anesthesia. Chirurg Many hospitals have however an insurance plan of using general anesthesia for some surgeries on adults and all surgeries on children. Some could have a general policy of local anesthesia for several surgeries to help keep down cost. Some will ask the patient which type of anesthesia he prefers plus some will switch to another 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 gives the individual a premedication, typically a type of benzodiazepine like midazolam (versed). The premedication is normally 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 patient calm and drowsy, to eliminate worries, to alleviate pain and hinder the individual from memorizing the preparations that follow. The repression of memory is seen as the most important aspect by many medical professionals, but this repression will never be totally effective in order that blurred or confused memories can remain.
The individual, and especially children, will often 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 your patient is wheeled into a preparatory room where in fact the induction of anesthesia occurs, or directly into the operation room.
MEASURES PERFORMED RIGHT BEFORE ANESTHESIA
Before anesthesia is initiated the patient will be connected to several devices that may stay during surgery and 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 circulation pressure. He will also get a syringe or perhaps a tube called intravenous line (IV) into a blood vessel, typically a vein in the arm. A few electrodes with wires are also placed at the chest or the shoulders to monitor his heart activity.
Before proceeding the anesthetist will once more check all the vitals of the individual to make sure that all areas of the body work in a way that allows the surgery to take place or to detect abnormalities that require special measures during surgery.
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 by 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.
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 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 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 round the end of the laryngeal tube that’s inflated to help keep it set up. 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.