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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, a teenager or an adult have surgery, more information on preparations are performed. Through the surgery the bodily processes 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 the measures are basically the same for children and adults, however 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. All the measures are not 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 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 need place in home prior to going to hospital.

For surgeries in the abdominal 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 in some laxative solution that may 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 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 for some kind of hospital dressing, which will typically be considered a gown and underpants, or a sort of pajama.

If the intestines need to be totally clean, the individual will often also get an enema in hospital. This is often given as one or even more fillings of the colon through the rectal opening with expulsion at the bathroom ., or it is usually distributed by repeated flushes through 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 most likely get 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 the patient 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 could also ask the patient if he has certain wishes concerning 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 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 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 individual which kind 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 occur, the nurse will give the patient a premedication, typically a kind of benzodiazepine like midazolam (versed). The premedication is normally administered as a fluid to drink. Children will sometimes obtain it as drops in the nose or being an injection through the anus.

The purpose of this medication is to make the individual calm and drowsy, to take away worries, to ease pain and hinder the patient 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 patient, 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 that he calms totally down. Then your patient is wheeled into a preparatory room where in fact the induction of anesthesia occurs, or right into the operation room.

MEASURES PERFORMED BEFORE ANESTHESIA

Before anesthesia is set up the patient will be connected 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 perhaps a leg to measure blood 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 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 more check all the vitals of the individual to ensure that all areas 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 fresh 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 by 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 in to the rectum and continued with gas.

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

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

Then the anesthetist will start the mouth of the patient and insert a laryngeal tube through his mouth and at night vocal cords. Chirurg Zürich There exists a cuff around the end of the laryngeal tube that’s inflated to help keep it set up. The anesthetist will aid the insertion with a laryngoscope, a musical instrument with a probe that’s inserted down the trout that enables him to look into the airways and also guides the laryngeal tube during insertion.