What Happens Before, During and After Surgery

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, a teenager 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 prior to the surgery as such. Following the surgery the supporting measures are disconnected in a specific sequence.

All of the measures are essentially 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 really 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’s also cultural differences in the routines from institution to institution and at diverse geographical regions. Therefore everything won’t necessarily happen in exactly the same way at where you have surgery or simply work.

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


There will always be some initial preparations, 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. That is achieved by instructing the patient to avoid eating and only continue drinking at least one day before surgery. The individual will also be instructed to take some laxative solution which will loosen all stomach content and stimulate the intestines to expel this 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 which might be regurgitated and cause difficulty in breathing.

Once 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 a gown and underpants, or perhaps a sort of pajama.

If the intestines have 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 rectal opening with expulsion at the bathroom ., 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 most likely get a plaster with numbing medication at sites where intravenous lines will be inserted at a later stage.

Then the patient and in addition his family members could have a talk with the anesthetist that explains particularities of the coming procedure and performs an additional examination to make sure that the patient 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 may also ask the individual if he has certain wishes about the anesthesia and pain control.

The individual 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 a few 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 some others can be carried out with the patient 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 several surgeries to keep down cost. Some will ask the individual which type 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. Chirurgie Children will sometimes get 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 eliminate worries, to alleviate pain and hinder the patient from memorizing the preparations that follow. The repression of memory is seen as the most crucial aspect by many medical professionals, but this repression won’t be totally effective so that blurred or confused memories can remain.

The patient, and especially children, will often get funny feelings by this premedication and can often say and do strange and funny things before he could be so drowsy he calms totally down. Then the patient is wheeled into a preparatory room where in fact the induction of anesthesia occurs, or directly into the operation room.


Before anesthesia is initiated the patient will undoubtedly be connected 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 which will monitor the oxygen saturation in the blood (pulse oximeter) and a cuff around an arm or a leg to measure blood circulation pressure. He will also get 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 of the vitals of the individual to make certain all parts of the body work in a manner that allows the surgery to take place or 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.


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 in to the rectum and then continued with gas.

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

By many surgeries the staff wants the individual to be totally paralyzed so that he will 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 in the body, including the respiration, except the heart.

Then your anesthetist will open up the mouth of the patient and insert a laryngeal tube through his mouth and past the vocal cords. You will find a cuff around the end of the laryngeal tube that’s inflated to help 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 also guides the laryngeal tube during insertion.

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