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What to Expect During Your Perioperative Experience

Preoperative Interview

After your surgery is scheduled, an experienced pre-surgical nurse will conduct a preoperative interview. This may be done in person at the Pre-surgical Care Center (PSCC) inside Tanner Medical Center/Carrollton or at the hospital (Tanner Medical Center/Villa Rica and Higgins General Hospital in Bremen) where you will have your surgery, or it may be done through a telephone interview at your convenience. When visiting the PSCC or hospital as directed by Tanner staff, be sure to have your driver’s license/I.D. card and insurance card, as well as your Surgery Order Sheet and your current medications (or a list of them).

During the interview, the pre-surgical nurse will gather information about your medical history, conduct a physical exam and review your medications. Additional testing, such as X-rays, EKGs or laboratory tests will be completed at this time. Any questions that you have about anesthesia and the surgical experience can be answered during this visit.

At the conclusion of the interview, you will receive specific written instructions about what to do to prepare for surgery and what medications to take the morning of the surgery. You must make arrangements for a responsible adult to take you home after your anesthetic or sedation and surgery. You will not be allowed to leave alone or drive yourself home.

The Short Stay Unit

On the morning of your surgery:

  • Do not eat or drink anything after midnight (including mints, gum or candy).
  • Do not smoke or drink alcohol for 24 hours before your surgery.
  • Do not dip or chew tobacco or snuff after midnight.
  • Take medications as instructed by your presurgical care nurse, but only with a small sip of water.
  • If you use inhalers, bring them to the hospital the day of the procedure.
  • Brush your teeth or rinse your mouth, but spit out all of the water.
  • Take off any jewelry and remove any body piercings.
  • Do not use adhesive on dentures.
  • Do not wear contact lenses.
  • Do not wear nail polish (fingers or toes)
  • Follow your bathing instructions and do not put any lotions or powders on your skin
  • Do not shave near your procedure site for two days before surgery

You will be instructed to arrive at the short stay surgical unit (SSU) — also known as outpatient surgery — at a scheduled time, typically around two hours before your surgery. The SSU nurses will escort you to a private room to prepare you for your surgery. Your vital signs will be checked and you will have an IV placed at this time. After the SSU nurses have finished prepping you for surgery, your family members will be allowed to rejoin you as you wait for your procedure. During this SSU phase, you will be interviewed by a member of the anesthesia team. The anesthesiologist or a certified registered nurse anesthetist (CRNA) will review your medical history and discuss the anesthetic plan. You will also see your surgeon and have the opportunity to ask any last minute questions before going to the operating room.

The Surgical Suite

There are different types of anesthetics that may be used alone or in conjunction with another anesthetic for your operation or procedure. These include: local anesthesia, monitored anesthesia care sedation, regional anesthesia and general anesthesia.

Local anesthesia

A local anesthetic is used to numb a small part of your body. It is used when nerves can be easily reached by drops, sprays, ointments or injections. Local anesthesia does not affect a patient’s general awareness and may be combined with sedation.

Regional anesthesia

Regional anesthesia is where a large part of the body or limb is numbed to block pain sensation. These techniques, including epidurals, spinals and peripheral nerve blocks, can be used to help stop pain during the operation and to decrease pain afterwards. Like with local anesthesia, regional anesthesia does not affect awareness and is often combined with either sedation or general anesthesia. Regional anesthesia is often offered to patients having orthopedic or obstetric operations.

Monitored anesthesia care/sedation

During monitored anesthesia care (MAC sedation), a patient is moderately to deeply sedated using medications delivered through an IV. The patient is continuously monitored by an anesthesia provider and the sedation is carefully given so that the patient is able to breathe on his or her own, but remains asleep or unaware during the procedure. This is often given for endoscopic procedures, such as colonoscopies, EGDs and bronchoscopies. It can also be used in conjunction with regional or local anesthesia to decrease awareness during surgical procedures.

General anesthesia

A general anesthetic uses a combination of medicines to keep you unconscious and pain-free during an operation. Drugs are injected into a vein and/or breathed in as a gas into the lungs. A breathing tube will be placed into your windpipe while you are asleep to help you breathe while under the anesthetic. You will be unaware of the breathing tube. The tube is removed as you wake up after surgery.

No matter the type of anesthesia you receive, your anesthesia provider will be with you the entire time, and will remain focused on your level of consciousness, your vital signs and your level of breathing throughout the operation.

The Post Anesthesia Care Unit and the Post-operative Phase

After your surgery you will be taken to the recovery room, also known as the post anesthesia care unit (PACU), where you will stay for about an hour. A registered nurse, along with a provider from your anesthesia team, will closely monitor your blood pressure, heart rate, oxygen level and breathing while ensuring that you make a smooth transition from an anesthetized to an awakened state. Your recovery from surgery and anesthesia depends on a number of factors, including the type and duration of surgery and anesthesia performed. It is very important that your pain and nausea are managed. You will be asked to rate your pain on a scale of 0-10 or use a picture to rate your pain. If you are experiencing pain or nausea, we encourage you to communicate with your healthcare team who will make every effort to provide relief.

The length of your hospital stay will depend on the type of procedure and what your surgeon has specified. If your surgeon has decided you will be admitted, then you will be moved to a private hospital room. If you will be going home the same day as your procedure, then you will be taken back to the short stay unit. Once you are comfortable and able to tolerate a light snack, your IV will be removed and you will be prepared for discharge. A short stay unit nurse will review discharge instructions for home care and follow up appointments with you or your responsible party. You will receive a written copy of these instructions. Any questions you have concerning your discharge can be addressed at this time. Remember, anesthesia may affect your judgment for about 24 hours.

For your own safety, please follow these guidelines for 24 hours after surgery:

  • Do NOT drive any type of car, bike or other vehicle.
  • Do NOT operate any machinery.
  • Do NOT make important decisions or sign a legal document.
  • Do NOT drink alcohol, smoke or take other mind-altering substances.
  • Have an adult with you on the first night after your surgery.

It is our goal to provide you with a safe and comfortable perioperative experience. Feel free to speak up if you have any questions or concerns along the way.

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