What Happens Before, After and during Surgery

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This can be 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, an adolescent or an adult have surgery, more information on preparations are performed. Through 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 specific sequence.

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

The following is really 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’s 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 found in the choice 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 tract often should be totally empty and clean. That is achieved by instructing the individual to avoid eating and only continue drinking at least one day before surgery. The patient will also be instructed to take 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, to avoid content in the stomach ventricle that can be regurgitated and cause difficulty in breathing.

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

If the intestines have to be totally clean, the individual will often also get an enema in hospital. This could be given as one or more fillings of the colon through the anal opening with expulsion at the bathroom ., or it is usually 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 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 an additional examination to ensure that the patient is fit for surgery, like listening to the heart and lungs, palpating the stomach area, examining the throat and nose and asking about actual symptoms. The anesthetist could also ask the individual if he’s got certain wishes about the anesthesia and pain control.

The patient 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 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. Many hospitals have however a policy 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 keep down cost. Some will ask the individual which type of anesthesia he prefers plus some will switch to some other kind of anesthesia than that of the policy if the individual demands it.

When the anesthetist have signaled green light for the surgery to take place, the nurse will give the individual a premedication, typically a kind 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 purpose of this medication would be to make the patient 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 most crucial aspect by many medical professionals, but this repression will never be totally effective so that blurred or confused memories can remain.

The individual, and especially children, will often get funny feelings by this premedication and can 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 initiated 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 connected 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 a syringe or a tube called intravenous line (IV) 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 again check all the vitals of the patient to ensure 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 gives the patient a new dose of sedative medication, often propofol, through the IV line. Chirurg This dose gives further relaxation, depresses memory, and frequently makes the individual totally unconscious already at this stage.

INDUCTION OF GENERAL ANESTHESIA

The anesthetist begins the general anesthesia by giving gas blended with oxygen by way of a mask. It can alternatively 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 shall always get gas blended with a higher 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 will 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, like the respiration, except the heart.

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 is a cuff round the end of the laryngeal tube that is inflated to help keep it set up. The anesthetist will aid the insertion with a laryngoscope, a musical 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.

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