This can be 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 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 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 ranges 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. All 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 is perhaps 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, which some often will need place in home prior to 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 patient to stop eating and only keep on drinking at least one day before surgery. The patient will also be instructed to take 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 is not necessary, to avoid content in the stomach ventricle that can be regurgitated and cause breathing problems.
Once the patient arrives in hospital a nurse will receive him and he’ll be instructed to shift for some sort of hospital dressing, which will typically be considered a gown and underpants, or perhaps a sort of pajama.
If the intestines need to be totally clean, the patient will most likely also get an enema in hospital. This is often given as one or even more fillings of the colon through the anal opening with expulsion at the toilet, or it can be 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 often get 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 ensure the individual is fit for surgery, like listening to the center and lungs, palpating the abdominal area, examining the throat and nose and asking about actual symptoms. Chirurgie The anesthetist could also ask the patient if he has certain wishes about the anesthesia and pain control.
The patient 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 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. Many hospitals have however a policy of using general anesthesia for some surgeries on adults and all surgeries on children. Some may 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 and some will switch to some other sort of anesthesia than that of the policy if the individual demands it.
Once the anesthetist have signaled green light for the surgery to occur, 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 obtain 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 patient from memorizing the preparations that follow. The repression of memory is seen as the main aspect by many doctors, but this repression will never be totally effective in order 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 could be so drowsy he calms totally down. Then your patient is wheeled into a preparatory room where in fact the induction of anesthesia takes place, or directly into the operation room.
MEASURES PERFORMED BEFORE ANESTHESIA
Before anesthesia is set up the patient will be linked to several devices that will 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 that may 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. Several 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 make sure that all areas of the body work in a way that allows the surgery to take place or even to detect abnormalities that require 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. This dose gives further relaxation, depresses memory, and frequently makes the individual 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 an alternative be started with further medication through the intravenous syringe or through drippings into the rectum and then continued with gas.
Once the patient is dormant, we shall always get gas blended with a higher concentration of oxygen for some while to ensure an excellent oxygen saturation in the blood.
By many surgeries the staff wants the patient to be totally paralyzed so that he will not move any body parts. Then the anesthetist or a helper gives a dose of medication through the IV line that paralyzes all muscles in the body, like the respiration, except the heart.
Then your anesthetist will start the mouth of the patient and insert a laryngeal tube through his mouth and at night vocal cords. There is a cuff around the end of the laryngeal tube that is inflated to help keep it in place. 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 down into the airways and also guides the laryngeal tube during insertion.