Health Watch: Same-day surgery: An overview of what to expect

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Same-day surgery allows a person having an operation to go home later the same day.

Medical advances now have made it possible for many people to go home the same day of an operation. For this to happen, everything must go smoothly, and the person must feel comfortable. Any same-day surgery may become an overnight stay, if necessary.

For same-day surgery, people are asked to come in early. Usually, a person must check in at least an hour or two before surgery. Basic information is taken at the registration desk, and the person is brought into the surgery area.

Several questions and forms may need to be completed before surgery. Phone numbers for emergency contacts, insurance information and other basic personal information will need to be recorded. After this is done, the person is asked to change into a hospital gown. Then, they are taken to the surgery prep area.

The surgery prep room is where a person spends the final minutes before going to the operating room. A person generally lies on a portable bed with wheels as they wait. Most people will have an intravenous line started in the surgery prep room if they don't have one already. An IV almost always is necessary before going into the operating room. Inserting an IV involves putting a needle through the skin and into a vein, usually on the hand or forearm. A bag of fluid may be hung so that it drips into the IV.

Blood tests may be required, depending on the surgery and any medical problems. More than one person may ask about the person's medical history. Questions may include medical conditions, medications and allergies. People will be asked when their last meal was. A recent meal may cause the surgery to be canceled because of risks. It is important to answer all questions completely and honestly. The heart rate, blood pressure and temperature may be recorded, sometimes more than once.

If consent forms and other legal documents were not completed previously, they will need to be signed before surgery. The anesthesiologist usually comes to talk to the person about the anesthesia. Anesthesia is the medication used to control pain and to put people to sleep. A mild sedative may be given to relax the person.

Various healthcare team members may come to the person's bedside, some of whom the person has not met before. In some cases, family members will be allowed to wait in the surgery prep room with the person. At other times, this may not be allowed. If a person is not sure who someone on their healthcare team is, or what his or her role is, they should feel free to ask. Any last-minute questions should be asked at this time.

If the person has not already met the surgeon, the surgeon will introduce himself or herself. Or, the surgeon may come by and say hello if they have met already.

At this point, the person usually is wheeled to the operating room on a portable bed or in a wheelchair. Many people are drowsy or even asleep from a sedative given earlier. The actual trip to the operating room and the operation often are not remembered at all. The next thing most people remember is waking up after the surgery. People usually wake up in an area called the surgery recovery room. The recovery room usually is located next to the operating room area.

The initial few minutes in the surgery recovery room can be confusing. It is not unusual for people to wake up in the recovery room and have no idea where they are. People go from a deep sleep or heavy sedation to a room they have never seen before. For most people, the only thing they will remember when they wake up is the last few minutes before surgery. An oxygen mask may be in place when the person wakes up. The IV that was put in before surgery still will be in place. The blood pressure, pulse, breathing rate and temperature are monitored closely. Nausea is very common when people first wake up. Vomiting sometimes occurs. Pain medication is given as needed to control discomfort.

The recovery room often is busy with activity. New people come into the room after surgery as others are leaving. There may be loud beeping noises made by various monitoring machines.

When the person meets the criteria for discharge from the surgery recovery room, he or she will be transferred back to the same-day surgery area. After the anesthesia has worn off, the IV is removed, and the person can go home. Someone else must drive the person home in almost all cases. This is because the medication used for pain usually impairs the ability to function normally for several hours. The doctor or nurse should give home care instructions before a person leaves. A follow-up appointment and phone number for the doctor usually are given at this time. Any questions should be asked before a person goes home.

Comments

cbettin 6 years, 7 months ago

Dr. Brochert's article provides a good overview on same-day surgery except for one important fact that was omitted: It might not be a physician anesthesiologist who visits the patient and provides the anesthesia care. Certified Registered Nurse Anesthetists (CRNAs), who are advanced practice nurses with 7-8 years of education and training in the specialty of anesthesia, deliver approximately 30 million anesthetics to patients each year in the United States, a large percentage of these in surgery centers and doctors' offices. Nurse anesthetists were the first anesthesia providers, dating back as far as the Civil War. Today there are more than 37,000 nurse anesthetists in the United States. Their safety record is equal to that of their anesthesiologist colleagues, as numerous studies have shown. CRNAs are not required by law to work with anesthesiologists, but often do, primarily in the hospital setting. It is important for same-day surgery patients to know that if their anesthesia will be provided by a CRNA, they are in the hands of a highly educated and skilled provider who will stay with them throughout their surgery, monitoring their vital signs and adjusting their anesthesia as necessary. For additional information about nurse anesthetists, visit www.aana.com or www.anesthesiapatientsafety.com.

Christopher Bettin Senior Director, Communications American Association of Nurse Anesthetists

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AltitudeAdjustment 6 years, 7 months ago

Remember also, that technology today has all but eliminated the problems of monitoring blood gases and many of the risks associated with putting someone under. While all surgeries have some risk, adverse events associated with anesthesia are just a fraction of what they use to be. This can be attributed to both better training, better practices, and better technology. All Anethesiologists and CRNAs alike should be applauded for their contributions to the advancements in their field.

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