Surgery Today - Care after surgery
The last thing you may remember as a patient, before receiving a general anesthetic, is being wheeled into the operating room and lifted by hospital orderlies onto the operating table. You may not see the surgeon, who could be scrubbing for the operation or reviewing the information compiled on your case. The anesthetist and a few nurses may be in the operating room. You are feeling relaxed and drowsy because of the preanesthetic medications. A tube may be attached to your arm to drip an intravenous solution into a vein. The anesthetist may administer a dose of a drug such as sodium pentothal, a not unpleasant medication that brings on a deep sleep within a matter of seconds.
The Recovery Room
You will probably remember nothing after that point until you gradually become aware of the strange sounds and sights of a recovery room. The recovery room may contain a number of patients who have undergone surgery at about the same time, especially in a large hospital. Each is reclining in bed equipped with high railings to prevent a groggy, confused patient just recovering from a general anesthetic from falling onto the floor.
Nurses move briskly about the room, checking the conditions of the various patients. As each patient gains some awareness of the situation, a nurse puts an oxygen mask over his face and explains the purpose: to help restore the tiny air sacs of the lungs to their normal condition. During administration of the anesthetic, the air sacs can become dry and partially collapsed. The humidified oxygen mixture helps restore moisture to the inner surfaces of the lungs; by breathing deeply of the oxygen, the patient expands the air sacs to their normal capacity. Before the use of oxygen masks in the recovery room and deep-breathing techniques for patients recovering from the effects of an anesthetic gas, there was a much greater danger of pneumonia developing as a postoperative complication.
Nurses assigned to the recovery room are given a report on each patient arriving from the operating room and instructions about such matters as the position of the patient in the bed. One patient may have to lie flat on his back, another on his side, a third in a sitting position, and still another with the head lower than the feet. If the patient has received a general anesthetic, the nurses may be instructed to turn him from one side to the other at regular intervals until he is able to turn himself.
The patient's blood pressure, pulse, and respiration are checked at regular intervals by the recovery room nurses, who also watch for any signs of bleeding or drainage from the area of incision. The surgeon is notified immediately of any signs of complications. Because the recovery room usually is located next to the operating room, the surgeon can quickly identify complications and attend the problem without delay. Most surgical patients will remain in the recovery room for a few hours at the most, and when they appear to be able to manage somewhat on their own they are returned to their beds in the regular nursing area of the hospital.
The Intensive Care Unit
Critically ill patients or those with heart, lung, kidney, or other serious disorders usually are assigned to an intensive care unit where each bed may be isolated from the others in a glass booth designed to provide privacy and quiet during the recovery period. Patients can still be clearly observed from the central nursing station.
Patients in an intensive care unit are given continuous care by nurses. Electronic equipment is used to monitor pulse, blood pressure, heartbeat, and, when needed, brain function and body temperature. Other devices are available for making bedside measurements of bodily function and to obtain laboratory data such as blood chemistry without moving the patient from his bed.
Most surgical patients will be concerned about how much pain they will feel after leaving the operating room. It is not unusual to expect greater pain than is actually experienced; the incision may cause no more discomfort than the problem that required surgical therapy. Obviously, a minor operation will result in less painful discomfort than a major operation. Generally, the pain or discomfort associated with a surgical incision may last for one or two days, then subside over a period of perhaps three or four days. After that an occasional twinge may be felt in the area of the incision when shifting the body puts extra stress on the muscles or other tissues involved in the operation. During the hospital stay, medications will be available to help relieve any serious pain resulting from the operation.