What is an operation used for?

Educational talk

Facts about the type of anesthesia in the briefing before the operation

Anyone who has to undergo anesthesia is concerned about its safety. Before the operation, there is a doctor-patient conversation, among other things, to create space for questions and time for explanations.

An operation is pending. Depending on the severity of the procedure, many patients are worried about the operation, but above all they have to respect the need for general anesthesia. The operating doctor and the anesthetist (anesthetist) hold preliminary talks with the patient so that both sides, doctor and patient, can prepare for the procedure in the best possible way and ensure that the operation runs smoothly.

Various aspects of the anesthesia are discussed with the anesthetist in a preliminary talk (premedication talk). For example, if the patient has been taking medication on a daily basis up to now, the continuation of this medication must be considered on the day of the operation. In the case of a heart condition or other pre-existing conditions, the type of anesthesia must also be individually adapted in this regard.

Through this preliminary discussion, in which the anesthetist checks various parameters of the patient, the specialist can decide which type of anesthesia is suitable for the patient. The patient's state of health as well as the type and scope of the procedure are decisive for the choice of anesthetic method. In some cases, the state of health is checked again during the interview. It often happens that a further examination of the heart sounds (EKG) is carried out or an additional X-ray is ordered.

The decision on the type of anesthesia is made jointly by the doctor and patient. The anesthetist will explain his recommendation to the patient during the conversation, who in turn can turn to the expert with further questions. Despite decades of development of medicine and thus also of anesthetic techniques and their medication, every intervention is still associated with certain risks. Of course, the preliminary talk also takes place to explain these risks.

In the preliminary discussion, the doctor will explain to the patient how he should behave in the hours before the operation in order to enable the operation to proceed smoothly. This includes, for example, that the patient should have an empty stomach. Under "Operation day" you can find out what else has to be observed on the day of the operation.

General anesthesia - full control: This is how a patient is monitored under anesthesia

During general anesthesia, the patient's body functions are monitored with the help of numerous machines. However, if one understands the functions of the apparatus, this can help to reduce fears of the procedure and the anesthesia.

Every operation and every patient is different. But essentially the same values ​​are monitored in almost every patient during general anesthesia in order to ensure that the operation goes smoothly. This surveillance, the so-called monitoring, is to ensure that abnormalities are registered immediately and the doctors can act accordingly.

The following components are precisely monitored:

On the one hand, the patient is connected to an electrocardiogram (EKG). Electrodes connected with small adhesive pads are attached to the upper body. They transmit the heart rate and the heart rhythm on a screen, which makes this data visible and audible during the entire operation.

The blood pressure is also measured. The measurement is usually carried out with a cuff on the upper arm. In the case of major interventions or high-risk patients, a cannula in the artery is connected directly to a pressure sensor, which measures the blood pressure very precisely. This value is displayed on the monitor during the entire operation.

In many operations, the established methods also include measuring the core body temperature. The temperature probe is inserted into the esophagus, under the tongue or rectally (in the anus) and provides information about the body temperature. If a urinary catheter is connected, a temperature sensor can also be connected here.

In some cases, a stomach tube is inserted so that no air in the abdomen or gastric juice impairs the operation or the well-being after the operation. In addition, the anesthetist (anesthetist) monitors the breathing mechanics during artificial ventilation and checks the air content of oxygen, anesthetic vapors and carbon dioxide.

In the case of very large operations and special interventions, statements must be made about the blood flow to the brain. Then the brain waves of the patients are monitored - a so-called neuromonitoring.

All of these values ​​together give a very precise overview of the patient's current condition. The team can immediately notice the smallest deviations from the normal state and, if necessary, adjust them accordingly.

Surgery creates wounds that need to heal. How are these properly taken care of?

During an operation, the operating doctors (surgeons) have to get to the operating area of ​​the body. For larger operations, incisions are usually necessary, other interventions can now be carried out without major tissue damage (minimally invasive) through small stitches.

After the end of an operation, the resulting wounds must be carefully tended and cared for so that they heal quickly and do not become infected. Depending on the operation, these wounds can be anywhere: on the head, extremities, buttocks or trunk.

Larger wounds in the skin are usually sewn up after the operation. This brings the wound edges back into their original position and allows them to grow together. This process takes time, during which the injury can be painful. Wound pain manifests itself as drawing, stabbing, throbbing, or burning. Wounds in joint regions can lead to restricted mobility, swelling or an accumulation of wound fluid (secretion deposits). In order to promote the healing process, the affected body regions are immobilized after an operation and the patient is given painkillers.

As a rule, surgical scars are treated with pressure bandages. A pressure pad is attached over the wound pad with a gauze bandage. This stops the bleeding and protects the wound from germs and bacteria. In addition, wound healing is supported in some cases by ointments or drugs such as antibiotics

In rare cases, there may be difficulties in the healing process in the area of ​​the wound. For example, if bacteria get into the fresh wound, it can cause inflammation. In order to detect inflammation in the operating theater area and the wounds at an early stage, the wounds are therefore regularly checked and the dressings changed.

If fluid has collected under a wound, the patient will see this in the form of swelling and a feeling of pressure. The secretion can be punctured, i.e. sucked off. Sometimes a drainage system is also installed in the wound area. With this system, wound secretions can be drained away immediately and do not accumulate. This can have a positive effect on wound healing.

After major operations with an inpatient stay, plasters are usually removed by the nursing staff. Anyone who is allowed to go home with a plaster should talk to their doctor. This can explain exactly how to proceed in each individual case, for example when showering. In most cases, it is advisable to use waterproof patches for the first few days after surgery and to change them after showering. After a certain period of healing, an ointment can be used to massage the scar tissue. This stimulates the blood circulation and thus improves healing.

As long as none of the mentioned symptoms such as throbbing, burning or other pain appear in the area of ​​the wound and there are no other noticeable changes in the surgical area, the wound healing process can be assumed to be positive.

 

An operation with general anesthesia is due: What do I have to consider when it comes to nutrition?

If an operation with general anesthesia (general anesthesia) or partial anesthesia (regional anesthesia) is due, various preparations must be made on the day of the operation and precautionary measures must be observed. This includes giving up food and certain drinks.

Why should a patient come to the operation on an empty stomach?

The anesthetic drugs (anesthetics), some of which are inhaled, not only switch off consciousness and the sensation of pain, but also reflexes that are important for survival, such as the swallowing and coughing reflexes. Since an operation usually takes place lying down, there is a risk during the operation that the stomach contents will get into the throat, be inhaled and cause pneumonia or even lead to asphyxiation. Regional procedures are not always effective. In this case, general anesthesia is necessary. Therefore, sobriety before the operation (preoperative) is also very important for planned regional procedures.

When should you stop eating and drinking?

In general, you can eat up to six hours before induction of anesthesia. If the operation takes place in the afternoon or evening, it is advisable to only consume light meals, such as white bread with jam, in the morning - but more than six hours before the operation. Clear liquids, such as tea or juices without pulp, without alcohol and without fat, may be drunk in small quantities up to two hours before induction of anesthesia. Infants can be breast-fed or bottle-fed up to four hours before a procedure. Up to an hour before anesthesia (anesthesia), infants and young children can receive small amounts of clear fluid.

After the operation, it takes a while for all body functions to be restored. The effect of anesthetics wears off faster with today's drugs than it was a few years ago, but it takes time for them to be completely broken down by the body. If swallowing and coughing work again and there are no nausea or other complications, the patient may resume food relatively quickly after the operation, depending on the procedure. For operations on the eyes, arms and legs, the patient can drink small sips of water around thirty minutes after the operation and after one to two hours eat small amounts of light food such as soup, yoghurt or baked goods.

In major operations that involve the mouth, throat or abdomen or that involve an opening in the chest, the first fluid and food intake is delayed. The decision about the first sips should always be discussed with the doctor or the nursing staff, as the time depends on the patient's condition, but also on the type and severity of the procedure.