What Happens Before, After and during Surgery

  • April 5, 2023

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, more information on preparations are performed. During the surgery the bodily functions 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 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 a nearly complete report on 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 will not necessarily happen in exactly the same way at the place where you have surgery or perhaps work.

Greatest variation is perhaps to be found in the choice between general anesthesia and only regional or local anesthesia, specifically for children.

INITIAL PREPARATIONS

There will be some initial preparations, which some often will need place in home prior to going to hospital.

For surgeries in the stomach area the digestive tract often has to be totally empty and clean. That 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 that may 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, 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 will be instructed to shift to some kind of hospital dressing, that will typically be considered a gown and underpants, or a sort of pajama.

If the intestines have to be totally clean, the individual will most likely also get an enema in hospital. This could be given as one or more fillings of the colon through the rectal opening with expulsion at the toilet, or it is usually given 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 circulation pressure and pulse rate. Especially children will often get 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 sure that the patient is fit for surgery, like listening to the center and lungs, palpating the stomach area, examining the throat and nose and asking about actual symptoms. The anesthetist may also ask the individual if he has 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 aren’t stated at the initiative of the individual or the parents.

Technically most surgeries, except surgeries in the breast and some 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 some surgeries on adults and all surgeries on children. Chirurg Zürich Some could have an over-all policy of local anesthesia for several surgeries to help keep down cost. Some will ask the patient which kind of anesthesia he prefers and some will switch to another 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 will give the patient a premedication, typically a kind 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 objective of this medication is to make the patient 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 so 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 that he calms totally down. Then the patient is wheeled right into a preparatory room where the induction of anesthesia takes place, or directly into the operation room.

MEASURES PERFORMED RIGHT BEFORE ANESTHESIA

Before anesthesia is initiated the patient will undoubtedly be linked to several devices which will stay during surgery and some time after.

The patient will receive a sensor at a finger tip or at a toe linked to a unit that 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 yourself a syringe or a tube called intravenous line (IV) right into a blood vessel, typically a vein in the arm. A number of 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 of the vitals of the individual to make sure that all parts of the body work in a manner that allows the surgery to take place or to detect abnormalities that require special measures during surgery.

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

INDUCTION OF GENERAL ANESTHESIA

The anesthetist begins the general anesthesia giving gas blended with oxygen through a mask. It can as a substitute be started with further medication through the intravenous syringe or through drippings into the rectum and continued with gas.

Once the patient is dormant, we will always get gas blended with a higher concentration of oxygen for some 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 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 center.

Then the anesthetist will open up 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 keep it set up. The anesthetist will aid the insertion with a laryngoscope, an instrument with a probe that’s inserted down the trout that enables him to look down into the airways and also guides the laryngeal tube during insertion.