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This is 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, a long list of 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 essentially 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 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 a similar way at the place where you have surgery or perhaps work.

Greatest variation is perhaps found in the decision between general anesthesia and only regional or local anesthesia, especially for children.

INITIAL PREPARATIONS

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

For surgeries in the abdominal area the digestive system often needs to be totally empty and clean. This is achieved by instructing the patient to avoid eating and only keep on drinking at least one day before surgery. Chirurg The individual 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 when a total stomach cleanse is not necessary, in order to avoid content in the stomach ventricle which might be regurgitated and cause breathing problems.

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

If the intestines have to be totally clean, the patient 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 toilet, or it is usually given by repeated flushes through a tube with the patient in laying position.

Then the nurse will take 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 could 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 stomach area, examining the throat and nose and asking about actual symptoms. The anesthetist could also ask the patient 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 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 a policy 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 patient which kind of anesthesia he prefers plus some will switch to another kind 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 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 objective of this medication is to make the patient calm and drowsy, to eliminate worries, to alleviate 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 so that blurred or confused memories can remain.

The individual, 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 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 RIGHT BEFORE ANESTHESIA

Before anesthesia is set up the patient will undoubtedly be linked to several devices that may stay during surgery plus some time after.

The patient will receive 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 a leg to measure blood 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 couple of 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 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 will start the general anesthesia giving gas blended with oxygen by way of 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 a few while to ensure an excellent oxygen saturation in the blood.

By many surgeries the staff wants the patient to be totally paralyzed in order that he does not move any body parts. Then the anesthetist or a helper will give a dose of medication through the IV line that paralyzes all muscles within the body, including the respiration, except the center.

Then your anesthetist will start the mouth of the individual and insert a laryngeal tube through his mouth and past the vocal cords. There is a cuff around 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.