This is 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, a teenager or an adult have surgery, more information on preparations are performed. During the surgery the bodily processes of the patient is supported and monitored by the means already prepared before the surgery as such. Following the surgery the supporting measures are disconnected in a specific sequence.

All the measures are fundamentally the same for children and adults, but 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 listing of all measures undertaken by surgery and their typical sequence. All 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 a similar way at the place where you have surgery or simply work.

Greatest variation could very well be to be found in the decision between general anesthesia and only regional or local anesthesia, especially for children.

INITIAL PREPARATIONS

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

For surgeries in the abdominal area the digestive system often must be totally empty and clean. This is achieved by instructing the individual to avoid eating and only continue drinking a minumum of 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 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 can 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, that 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 even more fillings of the colon through the rectal opening with expulsion at the bathroom ., or it might be given by repeated flushes through 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 will have a talk with the anesthetist that explains particularities of the coming procedure and performs an additional examination to make certain the individual is fit for surgery, like hearing the heart and lungs, palpating the stomach 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 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 are not stated at the initiative of the individual or the parents.

Technically most surgeries, except surgeries in the breast and a few others can be performed with the individual awake and only with regional or local anesthesia. Many hospitals have however an insurance plan of using general anesthesia for some surgeries on adults and all surgeries on children. Some could have an over-all policy of local anesthesia for certain 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 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 purpose of this medication is to make the patient calm and drowsy, to take away worries, to alleviate pain and hinder the individual from memorizing the preparations that follow. The repression of memory is seen as the main aspect by many doctors, but this repression won’t 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 occurs, or right into the operation room.

MEASURES PERFORMED BEFORE ANESTHESIA

Before anesthesia is set up the patient will undoubtedly be linked 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 perhaps a leg to measure blood circulation pressure. Chirurg Zürich He will also get yourself a syringe or perhaps a tube called intravenous line (IV) into a blood vessel, typically a vein in the arm. Several electrodes with wires may also be 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 that all parts of the body work in a way 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 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 stage.

INDUCTION OF GENERAL ANESTHESIA

The anesthetist will start the general anesthesia giving gas blended with oxygen through a mask. It can alternatively 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 high concentration of oxygen for some 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 will 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 your anesthetist will open up the mouth of the individual and insert a laryngeal tube through his mouth and past the vocal cords. You will find a cuff round the end of the laryngeal tube that is inflated to keep it in place. The anesthetist will aid the insertion with a laryngoscope, a musical instrument with a probe that’s inserted down the trout that allows him to look down into the airways and in addition guides the laryngeal tube during insertion.