surgery fear PLEASE ANSWER ME

CEN35 · Sep 25, 2001

when you get a general........they put a catheter in......so don't worry. the last thing they want is for you to pee all oover the table. i have a friend that works pacu, he says they really don't see much in the way of n&v post surgery. i am sure you will do fine...........try not to worry!!! :)

me

JennieBSN · Sep 25, 2001

Hey!! Relax!! I've had surgery 4 times, twice w/general anesthesia. Rick is correct, they put a catheter in if you have general, but usually you're already knocked out when they do so it doesn't hurt.

As for the N&V, well, I never had any problems. The most I remember was feeling like my head was weighted down with bricks...it felt so heavy. That's about it.

Remember, surgery is a lot safer now than it used to be. My patients who get general don't have much problem w/ N&V, as most of the CRNA's will push some Reglan or Phenergan IV prior to extubating.

You'll be fine!!

hoolahan, ASN, RN · Sep 25, 2001

I worked in a PACU for a period of time, but not all pt's get a foley with general. BUT most pt's do recieve atropine as a pre-med to decrease salivation to prevent aspiration of oral secretions. Atropine has the side effect of causing urinary retention, and is usually the culprit behind having to cath someone who has not voided post-op.

I won't say I have never seen anyone pee themselves in the situation you describe, but it is usually the elderly, due to lack of bladder tone.

You do not say what kind of surgery you are having, so I cannot evaluate what other options you may have. I would advise you, that when you have to meet with the anesthesiolist in Pre-admission testing, assuming you are not in overnight, you ask about options, such as epidural anesthesia, or spinal. Don't worry about spinal too much, nowadays with proper hydration, spinal headache is a very rare thing.

As for N&V, not as common anymore either, but the poor people who do, it is hard to get under control even with meds. It is best warded off intra-op with a dose of anti-emetic, which is a preference of the anesthesiologist. My husband never retched or vomitted after his first laminectomy, but after the second, whoa baby, he was a very sick pup for several hours post-op. To me, this says it was a difference in the anesthesia, which does not involve just the general agencts, but anti-emetics, sedatives, pain meds, etc. Anesthesia is a real art of you ask me. Sometimes it may be the morphine for pain that causes the N&V. For these pt's we have used toradol if the risk for bleeding is small, and if renal fcn is WNL. I personally tossed cookies for over a day after one dose of percocet, but have no problem with tylenol #3.

You really need to have a long conversation with the anesthesiologist to get answers to your questions. Don't let them blow you off with answers you don't understand, keep seeking clarification. I have seen some pt's whisked through the anesthesia interview where the anesthesiologist is simply concerned with getting his history and ENT exam done, and won't give pt's too much time of day. Mind you not all, but I just warn you to be persitent, don't worry about seeming like a PIA!

Also, realize that you may not be given your anesthesia by the same person you met with or who interviewed you, so you need to be sure they have documented your wishes, ask them to write any special instructions on your anesthsia consent form, AND in the progress notes, and watch them do it.

Any professional will not blow off your concerns. You should not sign anything until you are feeling very sure about it. Also, not to be glib, but this is why tranquilizers were created. Ask for one the night before surgery, or even a few nights before, you sound very anxious. Definitely ask for a sleeping pill the night before.

Good luck, I'll keep you in my prayers.

KellyandtheBoys · Sep 25, 2001

With general anesthesia I'm sure they put a catheter in. I've had surgery a few times in the past. And, I've always woken up with a catheter in. As far as N/V goes, you'll have medicine prescribed for you after surgery. Don't be afraid to use it if needed. The last time I had surgery (in February ) I had no nausea at all I mentioned my usual nausea after surgery to my Dr. My anesthesiologist gave me anti-emetics during or berore surgery. Good Luck, I"m sure you'll do great.

WriteStuff · Sep 25, 2001

:cool:

Analucia,

If this is the first "major" surgery you have ever had it's "normal" to have some fear and apprehension. I used the word "major" because you referenced the time as being 1 1/2 to 2 hrs.

I've had a couple of major surgeries in my lifetime so can speak from experience in addition to being a Nurse.

First and foremost, try to put out of your mind every body elses "horror stories" of their own experiences!!

And DO keep in mind that undergoing surgery today is far more "patient friendly" than it ever used to be, despite the fact that risk is always involved.

When you go in for your surgery you will either come to the hospital from home at the designated time, or be admitted a day in advance if pre-op testing, etc. demands such. ( Cost containment in today's health care industry precludes "day before surgery admissions", so probably all of your pre-op requirements i.e., lab work, x-rays, EKG, etc. will be done prior to your admission for the surgery.)

The day of your surgery you'll be taken to the pre-op area, where the Nurses, Anesthesiologist, and possibly your Surgeon will all be present. The usual, "empty your bladder, disrobe, and don this lovely hospital gown" will be the agenda.

Once your're on the guerney things begin to move along...

they will go through a certain amount of paperwork, start an IV in the holding area, and give you time to ask any questions you still have.

Depending on how nervous they notice you are, they might give you some IV sedation pre-op. Or, DO REMEMBER, you can request to have it, if nobody offers!!

Once in the OR, the anesthesiologist will place the mask over your face and you will be breathing wonderful, cool oxygen, while h/she gives you some IV sedation that will put you to sleep before you can get to "98" counting backwards from 100.

The wierd thing about surgery is: you go to sleep and wake up "seemingly" in the same moment! Operation over......

and maybe feeling some pain, but the Nurses already have orders for your pain med in Rec. Room and SHOULD be assessing you for your need, and giving it accordingly.

If a foley catheter is required it is inserted while you are "out."

Again remember, as you are waking up, and if you are feeling severe pain, you can ask for pain medication. You will be pretty "groggy" in Rec. Room and have lapses in and out of consciousness, but aware of what 's going on around you.

We have much better medications today for pre and post op surgery and nausea and vomiting post-op is not a MAJOR problem across the board. It wouldn't be fair to tell you that you will not experience N/V......it is very much an individual thing.

Learning as much as you can about your surgery and what can be expected post-op is a wise thing to do.

Here's a joke you can tell your surgeon:

"What's the difference between God and a Doctor?"

Answer: God knows He's not a Doctor!

Good luck, and let us know how things go!

Bonnie C., RN

ADN 2002 · Sep 25, 2001

Analucia,

If you're comfortable telling us, what kind of surgery are you having?

I had surgery this past June, my gall bladder was removed (lap chole). What happened with me was that I was admitted the previous day - during that time, they started my IV and gave me fluids, kept me NPO and did my pre-op stuff (chest x-ray and bloodwork). The day of surgery, they got me up early so I could shower (b/c I would not feel up to it later). A short time later, they came and got me and took me to pre-op where they gave me something to relax me (i can't remember what it was). After that, they took me into the OR, where the anesthesiologist gave me a mask of O2 and after that, he injected some medication (again, i can't remember what) into my IV. Less than a minute later, I was out.

And, like WriteStuff says, you "seemingly" wake up in the same moment (this is the weirdest feeling in the world b/c you know in your rational mind that you have lost time - about an hour in my case). When I came to (sort of) in the PACU, I was in pain but they assured me over and over that I had been medicated. I was still in pain when I was taken back to my room (not sure how long this was, but seemed like a few minutes at the time - most people are in the PACU about an hour, I think). My nurse immediately got me a shot of Demerol and Phenergan, and I got relief quickly. I didn't have problems with N/V (maybe b/c I had the Phenergan), but I did wake up with a catheter, which they removed when I got to my room b/c they wanted me up ASAP. I guess they figured I would need to go to the bathroom in the near future, so I would have to get up if they took the catheter away.

I do have a case where a pt (my dad) did throw up after surgery. He had had a general, and when he woke up he drank a lot of orange juice (why the nurses let him do this, I'll never know...). He dropped something and when he bent over the side of the bed he probably put some pressure on his stomach and up came all that juice! But that's the only case in my recent memory, and you'll probably have an order for something for nausea post-op, so I would not worry about that too much.

Hope this helps to make you feel better! :)

aimeee, BSN, RN · Sep 25, 2001

Analucia, when I had an ovary removed and a tubal ligation 6 years ago they put a cath in me. I don't remember being in post op at all. First thing I remember I was being wheeled into my hospital room. I INSISTED that I had to pee, even though I had a foley in, and wanted to get up! They finally convinced me to lay back and relax and let the foley do its work.

BrandyBSN · Sep 25, 2001

I had surgery 3 months ago, and was under a general, but they did not cath me. I didnt pee though :)

The two things that bothered me the most were that I didnt remember anything, and I woke up crying. The nurse told me that a lot of people wake up crying, something to do with a hormonal release.

It wasnt bad, but I was scared to death before. It will be ok.

BrandyBSN

mustangsheba · Sep 25, 2001

Analucia: What a beautiful handle. As everyone else has advised, talk to your anesthesiologist. Don't be brave. When I was in pre-op, I told the nurse I needed something for anxiety, that I was scared and nervous, and, by the way, so was the lady next to me (who denied her anxiety stoically, all the while clasping her hands and shaking like an aspen leaf.) He gave us both the IV medication I was hoping for. It instantly (I mean in the blink of an eye!), removed that scarey feeling. When I awoke, they told me they had had some trouble controlling my pain while coming out of anesthesia. However, I have no recollection of that - not then, not now. I always experience nausea when coming out of anesthesia. There are many medications that are effective - phenergan, vistaril, inapsine, zofran. I expect to be nauseated, therefore I am. Don't do what I do, do what I say. Expect and envision coming through with flying colors. It is normal to feel afraid going in. Trust that you will be in good hands and discomfort will be minimal. And above all, voice your concerns. I send you peace and love.

Pam RN · Sep 26, 2001

As an OR nurse I can tell you that not all patients receiving a general have a foley put in. If you're having a hysterectomy they will, if you're having a lap chole they may or may not, doctor's preference. Don't worry if you don't, you won't pee the bed. If you're having a gyne laparoscopic surgery for say an oophorectomy or an ovarian cystectomy you'll get a foley after you're asleep and will be removed before you wakeup.

When you get your pre-op "cocktail" you should feel very relaxed, thanks to the versed. The induction agent used is propofol and it looks like milk in your IV. It may burn going in but they usually put some Lidocaine in with it to take the burning sensation away. We don't tell people to count back from 100 anymore because the induction goes quick. We tell people to pick out a good dream. It's better to drift off to sleep thinking of Paris or laying on a beach with an umbrella drink! My brother had his deviated septum repaired last year and he said going off to sleep was really nice. I agree. The anesthesia gases they use cause you to get that feeling that time is shorter than it is. So when you wake up and feel that you've only been asleep for 5 minutes or less its the gases. I had open heart surgery for a valve replacement and I went into surgery at 7a.m. and when my memory returned it was after 3p.m. but it only felt like 10 minutes. Very strange. I won't tell you not to worry because it's not an easy thing. But, hopefully this information will help you plan in your rational mind what to expect. We also tell people to go ahead an worry so we don't have to!! Good Luck!

essarge · Sep 26, 2001

I had surgery twice within a month. The first time when I came out I felt very nausious, so when I went in the second time I told them about it. The doc said that I was probably one of those people that needed to be brought out of it fast. Whatever they did worked, I felt fine. By the way I had a total hysterectomy (best decision I ever made!)

The feeling of apprehension is very familiar to me and I can tell you it really hit me the day I went in the second time. The idea that I had no control over anything after they "knocked me out" was one of the scariest thoughts I've ever had. No matter what anyone said to me, the feeling wouldn't go away. They gave me valium the night before and that still didn't work. The one thing that helped allot was in pre-op, I was assigned a very caring nurse who told me that she would be with me all the way through and wouldn't let anything happen to me. She was there when I went out and when I woke up she was there again, soothing me and showing total care. It was the nurse that made the big difference for me!! Her care and compassion really counted and I will never forget her!!