Day of the operation:
Often, surgery will begin
in the morning, unless the operation is "following"
another. A typical start time will be 7:30 AM or 8:00
AM. The patient will have been instructed to not eat
or drink anything for at least six hours before surgery.
This decreases the risk of aspiration during the intubation
process (the placement of a breathing tube into the
lungs, by the anesthesiologist).
The patient will often be given a
sedative just before going back to the operating room
(OR). In the OR, there will be a lot of activity,
which might be disconcerting to the patient. What
the patient must remember is that all the activity in
the room is for the benefit of the patient. Everyone
is focused on a particular task, in order to make sure
the patient has a safe and successful surgery.
The room may seem cool, and the personnel might appear
impersonal, but this is only because they are focused
on a number of tasks.
Various lines may be placed. This
means that the patient might have additional intravenous
(IV) lines started, to supply fluid. A central line,
which is essentially a large IV placed either under
the collar bone or into the jugular vein in the neck,
might be inserted. Although this sounds like a big deal,
for an anesthesiologist this is a routine task. A Foley
catheter to drain the bladder may be placed if the procedure
is anticipated to last several hours. An arterial
line, which is essentially a line to measure arterial
blood pressure instantly, might be placed. Some of these
lines might be placed after the patient is put to sleep.
Next the patient will go to sleep.
The anesthesiologist will insert the endotracheal tube
into the lungs (this will breathe for the patient while
asleep). The patient will then be positioned appropriately
for the surgery, with the knees, elbows and any other
delicate areas carefully cushioned to decrease the risk
of pressure sores.
The surgeon will then usually mark
the skin in the region of intended incision. The
circulating nurse will "prep" the skin with
antibiotic solution and scrub, and the scrub nurse will
"drape" the patient with towels and an iodine
impregnated plastic "sticky" drape known as
ioban. The remainder of the body is now draped
While the body is being prepped and
draped, the surgeon will generally "scrub"
his hands and forearms. He will then enter the
room, "don" his gown and gloves, step up to
the field, and start operating.