Page 37 - University of Martland Nursing Forum - Winter 2017

I have patients who expect to be able
to go back to work the same afternoon when having an outpatient procedure.
I inform them that if you are having an anesthetic, you are considered “under the influence”—much like drinking and driving—and it is best not to plan any activities that require your full focus immediately after surgery. As far as exercise or rest, normal activities are encouraged up to the time of surgery, unless otherwise instructed.
Q: What typically happens on the day of a surgery?
GONZALEZ: You will arrive at the facility and be checked into a preoperative room. You’ll review and sign paperwork, including surgical/procedural consents. This may also be when you
see your surgeon(s) and anesthesia provider(s). This is an opportunity to ask any last-minute questions and address any concerns you may have. You may have an IV line started and have
blood drawn or additional lab work done. You might also have an electrocardiogram, if indicated, or
other specified preoperative testing.
Q: What drugs will I be given during surgery?
GONZALEZ: This is dependent on the type of procedure being done and can vary from sedation to a regional or general anesthetic. Sedation involves
the use of an amnestic, a hypnotic, and pain medications that are regulated
for your comfort and your vital signs, such as respiratory rate, heart rate, and blood pressure. Regional anesthetics, often called a “block,” include sedation and pain medication to facilitate the placement of the block with a local anesthetic. Regional anesthetics have the added benefit of providing anesthesia for the surgery and into the recovery period. If your procedure requires a general anesthetic, meaning you will go to sleep completely, you will receive a variety of medications from a number of different categories to ensure your comfort during the procedure. Throughout all types
of anesthetics, you will be continually monitored by your anesthesia provider.
Q: What steps can I take to improve rehabilitation after surgery?
GONZALEZ: Discussing realistic expectations with your surgeon is an important aspect of advocating for yourself postoperatively. Following postoperative instructions is the most important thing you can do to aid your recovery. You will be given instructions on what you can and cannot do after surgery; pushing yourself beyond your limits may cause setbacks. This is not the time to take on additional tasks because you are “home recovering.”
Q: Is there a certain day/time I should schedule my surgery?
GONZALEZ: There are many variables that impact this, many of which we cannot control. Often, we are provided a few options for scheduling procedures based on the availability of our surgeon. Talk with your surgeon if you have
a specific scheduling request. There
are advantages and disadvantages of scheduling your procedure early versus late. The most common thing I hear from patients that have later procedures is
that they are hungry or thirsty or have a headache because they didn’t have their morning caffeine. In these cases, make sure you eat and/or drink something right up to the time that you are told to stop. For example, if your procedure is at 2 p.m. and you have been instructed that you can have a light breakfast and liquids until 8 a.m. the morning of surgery (nothing by mouth for six hours), have some toast and drink your coffee; don’t skip it.
Q: What are possible complications of surgery with anesthesia?
GONZALEZ: Complications fall
into either surgical complications
or anesthetic complications and
can be classified as minor or major. Complications are addressed during
the consent process. If they haven’t
been, you should ask this very question. The most common complications of surgery include unanticipated bleeding, uncontrolled pain, and infection. Anesthetic complications can include prolonged nausea and vomiting, allergic reactions to medications received intraoperatively, prolonged awakening, or unanticipated airway issues. Incidences of complications also depend on whether you have other medical conditions that make you a higher risk for surgery and anesthesia, such as cardiac disease or uncontrolled diabetes.
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