The Day of Surgery

| February 8, 2013 | 2 Comments

The day of surgery can provoke a variety of emotions, from excitement to anxiety and sometimes fear.  Learn about the important events on the day of surgery so that you can be more informed.

Everyday, all types of surgery and procedures are performed.  Gastric surgery and spine surgery.  Knee surgery and shoulder surgery.

From the top of your head, to the bottom of your feet and everywhere in between, surgery can take place.

Some surgeries may be minutes long and others many hours in duration.  They may take place in a large hospital, a smaller community hospital, a surgery center, a procedural suite, or a doctor’s office.

You may go home the same day, a few days later, or a week later depending on the case.  Surgeries take place on all ages of patients, even fetuses, and at all times of the day and night.  Patients with no medical history and those with a variety of medical issues undergo surgeries.

So what should you expect on the day of YOUR surgery?  Some common themes will likely be present.

The first of these is the requirement to avoid eating or drinking on the day of your surgery.  This is called your NPO status.  The reason this takes place is to try and minimize the risk of gastric aspiration, which is when stomach contents enter the lungs.

Gastric aspiration can lead to undesirable outcomes including pneumonia, and that is why you are constantly asked, “When is the last time you have had anything to eat or drink?”.  It goes without saying that it is very important to be honest about this question when asked.

You will likely have talked to your surgeon or his or her colleague several times before the day of surgery.  In addition, your anesthesiologist may have called you the night before.

On the day of surgery, you will be asked to arrive early for many reasons.  Some of these reasons are to complete lab work, to review paperwork, and to update your medical history.  Arrangements may need to made for post operative care at this time as well.

When you arrive to the hospital (this term will be used in reference to all of the places where your surgery may take place), you will be taken to the pre procedure area.  At this time, you will be asked to change into a hospital gown.  Depending on the procedure, you may need to remove all of your clothing underneath the gown.

This is simply to insure your safety.  For instance, some undergarments and jewelry may heat up during surgery and cause a burn.  Your clothes and belongings will be kept in a safe place or with your family until it can be returned to you.

During this time, you will meet several different members of the healthcare team.  Everyone will ask you some of the same types of questions multiple times, but do not be discouraged.  This is all to make sure we keep you as safe as possible.  Your vital signs will be checked, including your blood pressure, heart rate, respiratory rate, oxygen saturation, temperature, height, and weight.

For an example, we can use a patient undergoing a spine surgery.  The patient will meet with a nurse to review medical history and obtain vital signs.  They will speak to the surgeon and the anesthesiologist.  The surgical technician and surgical assistant working with the surgeon may speak with you.

A neurological monitoring technician may be working on the case as well as a physician assistant or surgical assistant.  The circulating nurse from the operating room will be introduced.  And there can be many more people involved.  The point is that you should not be fearful of this and get frustrated.  Everyone is trying to make sure that the surgery gets done safely and with the highest of standards.

During the time you are in the pre procedure area, an intravenous line will likely be started.  This is the “iv.”  The iv is placed into one of your veins and is a small tube through which medicines and fluids can be given to you.  The iv is usually placed into a hand or arm, but may be placed many other areas as well.  The iv placement is often something that many people fear, so please read more about them here if you are nervous!

You will meet the operating room nurse or circulating nurse prior to heading to the operating room.  Get to know this person well!  They are of utmost importance and are there to insure your safety before, during, and immediately after your procedure.  They will accompany you throughout the time you are in surgery.

Also, you will visit with your anesthesiologist.  An anesthesiologist is a physician who is trained to take care of you throughout the entire surgical experience.  He or she will be providing anesthesia, so that you are safe and comfortable throughout the surgery.  Anesthesiologists are trained to take care of all types of patients undergoing all types of procedures.  In many cases, you may have an anesthesiologist that is even further trained in specific areas of anesthesia, such as pediatric anesthesia or cardiac anesthesia.

And finally, you will speak with your surgeon.  Rarely, a surgeon may need to respond to an emergency in between cases and may not be immediately available to speak with you prior to the surgery.  In this case, many patients feel comfortable proceeding to the operating room, because they have spoken with the surgeon earlier in the day.  Our surgical colleagues are your advocates, and if they are not immediately available, you may certainly ask to wait until you speak with them prior to going to the operating room or procedural area.  Don’t worry, everyone on the healthcare team understands this!

After you have spoken with all of the necessary people, the operating room is ready, the surgeon is ready, and you are ready, it is time to head to the operating room.  Depending on many different factors, including the type of surgery you are having, the anesthesiologist may give you some relaxing medicine through the iv.  Children undergoing surgery may have been given a relaxing medicine by mouth. The circulating nurse and anesthesiologist will then take you to the operating room. In specific instances, a parent may be asked to accompany the patient to the room as well.

You may be asked to walk to the room or you may be taken on a hospital bed.  On arrival to the room, you will be asked to move to another bed where you will be during the surgery.  If you are unable to move, don’t worry, there are plenty of people to help move you safely to the other bed.  Depending on the type of anesthesia being administered, you may not remember even going into the operarting room.  Your surgeon may be in the room at his time to greet you as well.

At this point, many different things may happen depending on the type of procedure you are having.  For instance, you may be having a baby and have epidural anesthesia in place.  Or you could be having a specific type of eye surgery in which anesthesia is placed to make your eye unable to feel anything.  You may be having a gallbladder removed and the anesthesiologist will be preparing to administer general anesthesia.  In any case, a set of vital signs will be obtained after you move onto the operating room bed.

**Sidenote: Please keep checking back as we update more and more articles related to specific types of surgery you may be undergoing.

Once the procedure is complete, you will taken out of the procedure room.  Depending on the type of surgery, you may have been awake the entire time, or you may have been under general anesthesia.  Or, you might have had sedation to cause you take a lighter nap.  All this will have been discussed with you by your anesthesiologist and surgeon.

After you leave the operating room (and depending on the type of anesthesia), you will be taken to one of several different places.  You may be taken to a room where your family is located, a recovery room where you will be monitored by nurses while your anesthesia wears off, or to the intensive care unit.

You may be going home the same day or you may be kept in the hospital overnight depending on the type of surgery.  Do not hesitate to discuss this with your surgeon and anesthesiologist.  In any case, you will be monitored either directly or very closely by an anesthesiologist and nurse as the anesthesia is wearing off.

Hopefully, you have learned more about the general overview of what to expect on the day of surgery. We want you to have the safest experience possible.

If you have had surgery recently, visit the forum and tell us about your experience. Thanks for visiting anesthesiamyths.com!

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Category: Anesthesia Topics, Anesthesiologist, Day of surgery, General Anesthesia, Obstetric Anesthesia, The Operating Room

Comments (2)

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  1. Rachael says:

    I just got back from having a laprascopy to remove an ovarian cyst and as it was my first every major operation I freaked out a bit. I had a lot of worries… about pain, about general anesthesia and etc. But I tell you… Dr. Joe is right and that you should really meet your Anesthesiologist before the operation. I’m very thankful that mine took the time to visit and chat with me the night before the operation. Plus, during the preparation they had trouble with my IV so he did the IV himself and spoke to me to calm me down. He also visited me in my room to check up on me the day after. So please, to anyone there who’s going to have their operation soon… there’s really no need to worry. Trust your doctors because they know what’s right for you. Btw, Thanks Dr. Joe and Dr. Dave!

    • DrJoe says:

      We are so happy that you had a good experience! Sounds like you had a superstar for an anesthesiologist as well. Thanks for sharing the story with us. I know it will help put a lot of other minds at ease. Take care!

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