1001 Sam Perry Blvd, Fredericksburg, VA 22401 Phone: 540-741-7614 http://fredericksburganesthesia.com PREPARING FOR SURGERY Questions and Answers Questions for After Surgery Q What is a Recovery Room? a. The Recovery Room (also known as the Post Anesthesia Care Unit or PACU) is an area adjacent to the operating room where you will wake up immediately after your surgery. Nurses who specialize in your transitional care between the operating room and either your discharge or your continued hospital stay staff the recovery room. AA of VA’s physicians oversee your care there to ensure you wake up safely and comfortably. Q What happens while I am in the Recovery Room? a. The anesthesiologist and PACU nurses administer to your recovery in the PACU. We will monitor your vital signs closely with the same type of monitors, which you had in the operating room, including an EKG, blood pressure cuff, and a clip on your finger called a pulse oximeter that monitors your oxygen level in your body. Your dressings or bandages are checked, changed or reinforced if needed. Your nurse may monitor various additional tubes and drains placed by your surgeon or anesthesiologist besides the IV you started with at the beginning of the case. You will wake up with either an oxygen mask on your face or nasal cannula in your nose again to ensure that you have a safe amount in your body. The nurse may ask you to assist in your postoperative care depending on what your physicians want you to accomplish. One example would be that the nurse might ask you to take deep breaths to help keep your lungs expanded. Q How long will I be in the Recovery Room? a. Our adult patients usually stay in the Recovery Room for about one hour. Your time may vary based on the procedure and the type of anesthesia that you received. Patients who receive minimal anesthesia usually leave sooner. Certain patients (for example those undergoing a carotid endarterectomy) may be observed in the recovery room for an extended period of time before they are transferred to their room. Our pediatric patients usually recover faster from their anesthetic and are usually reunited with their parents sooner than the hour timeline. Q When and where can I see my family after surgery? a. You will see your family after you have met our discharge criteria from the recovery room. Approximately an hour will have passed from the time you leave the operating room until you have met that discharge criteria. If you are having an ambulatory or outpatient procedure, then you will meet your family in our second stage recovery area or same day surgery area. If you are having an inpatient procedure, then you will meet your family in the privacy our your own hospital room. Q Can my family be with me in the recovery room? a. Unfortunately, we can’t allow your family in the recovery room due to privacy issues with the other patients that be receiving their care in the recovery room at the same time. Q How will I feel while I am waking up? a. Each person will vary as to how they feel when they awaken. Some patients will experience nausea, mild pain or discomfort, blurred vision, dry mouth and possible feeling cold. In the operating room, your anesthesia team will initiate the postoperative care by giving you medicine
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1001 Sam Perry Blvd, Fredericksburg, VA 22401 Phone: 540-741-7614 http://fredericksburganesthesia.com
PREPARING FOR SURGERY
Questions and Answers Questions for After Surgery
Q What is a Recovery Room? a. The Recovery Room (also known as the Post Anesthesia Care Unit or PACU) is an area adjacent
to the operating room where you will wake up immediately after your surgery. Nurses who specialize in your transitional care between the operating room and either your discharge or your continued hospital stay staff the recovery room. AA of VA’s physicians oversee your care there to ensure you wake up safely and comfortably.
Q What happens while I am in the Recovery Room? a. The anesthesiologist and PACU nurses administer to your recovery in the PACU. We will monitor
your vital signs closely with the same type of monitors, which you had in the operating room, including an EKG, blood pressure cuff, and a clip on your finger called a pulse oximeter that monitors your oxygen level in your body. Your dressings or bandages are checked, changed or reinforced if needed. Your nurse may monitor various additional tubes and drains placed by your surgeon or anesthesiologist besides the IV you started with at the beginning of the case. You will wake up with either an oxygen mask on your face or nasal cannula in your nose again to ensure that you have a safe amount in your body. The nurse may ask you to assist in your postoperative care depending on what your physicians want you to accomplish. One example would be that the nurse might ask you to take deep breaths to help keep your lungs expanded.
Q How long will I be in the Recovery Room? a. Our adult patients usually stay in the Recovery Room for about one hour. Your time may vary
based on the procedure and the type of anesthesia that you received. Patients who receive minimal anesthesia usually leave sooner. Certain patients (for example those undergoing a carotid endarterectomy) may be observed in the recovery room for an extended period of time before they are transferred to their room. Our pediatric patients usually recover faster from their anesthetic and are usually reunited with their parents sooner than the hour timeline.
Q When and where can I see my family after surgery? a. You will see your family after you have met our discharge criteria from the recovery room.
Approximately an hour will have passed from the time you leave the operating room until you have met that discharge criteria. If you are having an ambulatory or outpatient procedure, then you will meet your family in our second stage recovery area or same day surgery area. If you are having an inpatient procedure, then you will meet your family in the privacy our your own hospital room.
Q Can my family be with me in the recovery room? a. Unfortunately, we can’t allow your family in the recovery room due to privacy issues with the other
patients that be receiving their care in the recovery room at the same time. Q How will I feel while I am waking up?
a. Each person will vary as to how they feel when they awaken. Some patients will experience nausea, mild pain or discomfort, blurred vision, dry mouth and possible feeling cold. In the operating room, your anesthesia team will initiate the postoperative care by giving you medicine
1001 Sam Perry Blvd, Fredericksburg, VA 22401 Phone: 540-741-7614 http://fredericksburganesthesia.com
PREPARING FOR SURGERY
to try to prevent nausea and pain. They will have actively warmed your body while you were in the operating room. Your recovery room nurse will be there to continue with the warming and adding additional medications to assist with certain symptoms such as pain and nausea. Sometimes the medicine that the anesthesia providers give to reverse certain anesthesia medicines will give you that dry mouth sensation or blurred vision. Those sensations should not last very long.
Q Will I have nausea after surgery? a. Possibly.
Postoperative nausea and vomiting (PONV) is a common problem after surgery and anesthesia. It can occur in up to just over one-third of the patients (35%) in the ambulatory surgery patient population, and be as high as 70% in certain high- risk patient groups. AA of VA's anesthesiologists know that patients have listed the avoidance of nausea and vomiting as one of their top concerns when faced with surgery and anesthesia. We also know that certain patient characteristics are associated with a higher risk of PONV such as younger age, female gender, large body habitus, history of PONV or motion sickness, anxiety, etc. Just as important are certain types of surgery are also known to predispose to PONV such as head (eye, ear) and neck procedures, intra-abdominal surgery, laparoscopic and gynecologic procedures.
For our patients at low risk of PONV, no prophylaxis or minimal prophylaxis with either Decadron or Zofran would probably be given. For patients at moderate risk, we will give prophylaxis followed by aggressive treatment if nausea and vomiting develops. For those patients at highest risk, our anesthesiologists tailor an aggressive treatment regime consisting of Decadron, Zofran, avoidance of certain medications known to cause PONV, aggressive IV fluids, attention to postoperative pain control, and potentially altering our anesthetic technique. We may also add a Scoplamine transdermal patch if there are no medical contraindications to ordering this drug. While these various techniques may seem costly, they become cost-effective when the issues of your satisfaction and avoidance of unplanned admission are considered.
Q Will I have pain after my surgery? a. Probably. Most people feel some discomfort after surgery. Every person has different pain
thresholds that cause him or her to be subjected to pain differently even if they have undergone the same surgery. It will be important for you to speak up regarding your pain level to your health care providers so that we can treat you appropriately. If you have gone through surgery under either local or regional anesthesia, you may not have pain until the anesthesia wears off. Please do not hesitate to let us know if you are experiencing pain.
Q How do I describe my pain to my health care team? a. Your preoperative nurse will ask you describe your pain either on a number scale or a visual
scale. The number scale is based on numbers from zero to ten. By answering with a zero, you are telling the healthcare provider that you are experiencing no pain. If you are experiencing the worst pain ever, then you should tell the provider that your pain is a ten. The visual scale is based on smiles and frowns. A smile means no pain and a frown means that you are experiencing some pain. The facial expression changes based on the amount of pain that you are having. This will help us gauge how well pain relief measures are working for you so that medications can be adjusted to meet your needs.
Q What kind of pain medicine will I receive after surgery? a. Most patients will receive IV pain medicine to control their pain. Your anesthesiologist will choose
a particular medicine or acute pain management technique based on the type of surgery, your underlying medical history, the amount of pain you are having and your response to our interventions. In the recovery room, the typical narcotic medications that we prescribe are IV
1001 Sam Perry Blvd, Fredericksburg, VA 22401 Phone: 540-741-7614 http://fredericksburganesthesia.com
PREPARING FOR SURGERY
morphine, dilaudid, and fentanyl. Sometimes we give supplemental non-narcotic medications such as Toradol (a non-steroid anti-inflammatory drugs, like Motrin) or Tylenol. Your surgeon may also have prescribed other medications before your surgery that will give you additional pain relief as well.
Q If my pain is not controlled with medications, are there other options to help me? a. Yes, your anesthesiologist may be able to place local anesthesia either through a regional nerve
block or placement of an epidural to help control your pain. Your anesthesiologist may offer these regional anesthetic techniques (see acute pain section) preoperatively or postoperatively based on procedure-specific recommendations taking into consideration the surgical procedure, the location of your pain as well as the severity of your pain.
Q What are the benefits of adequate postoperative pain relief? a. Obviously the major benefit is to minimize your suffering. Good pain relief can also reduce
potential future illness and enable your rapid recovery and early discharge from hospital, which can reduce costs. Some potential short term negative effects of uncontrolled pain include emotional and physical suffering, sleep disturbances which could impact your mood, high blood pressure and tachycardia which could lead to heart problems, immobility which can lead to blood clots in legs or lungs as well as pneumonia, impaired breathing and bowel function such as nausea.
Being prepared is imperative so that you understand your responsibility for communicating to your healthcare givers your pain scale. Please ensure that you understand the pain measurement scale your nurse reviews with you prior to your surgery. Let AA of VA help you negate potential negative effects of uncontrolled pain by early intervention.
Q Can I drive myself home after the same day surgery? a. American Anesthesiology of Virginia, along with our facilities, recommend that you do not drive a
car or operate machinery for 24 hours after surgery. Due to the surgery and the medications we give you on the day of surgery, your ability to think, your dexterity, or some of your reflexes may be impaired. You will need to coordinate with family or friends to drive you home.
