What is Elective Surgery?
Selective surgery refers to surgery that can be performed at an appropriate timing. The grasp of the timing of the surgery will not affect the treatment effect. Allow sufficient preparation or observation before surgery, and then choose the most favorable timing for surgery. Such as surgery for benign lesions (common gastroduodenal ulcer gastrotomy, thyroid adenoma resection, hernia repair), plastic surgery and so on.
- Chinese name
- Elective surgery
- General anesthesia, spinal anesthesia, etc.
- Improve the patient's physical condition to reach the surgical standard
Selective surgical anesthesia and preoperative preparation
- 1. Anesthesia methods Common clinical anesthesia methods include general anesthesia, local anesthesia, and spinal canal anesthesia. The choice of elective surgical anesthesia method is based on the lesion or wound site, the degree of ease of operation, and the patient's condition. 2. Preoperative preparation (1) Psychological preparation: Preoperative patients will inevitably have emotions such as fear and nervousness. Therefore, they should be introduced and explained in detail to the patient's family members, obtain their trust and consent, and assist them in doing psychological work and eliminating concerns.
(2) Physiological preparation: Practice urine and proper cough and sputum before bed operation. Patients with water, electrolyte, acid-base balance disorders and anemia should be corrected before surgery. Take a number of measures before surgery to improve the patient's physique and prevent infection. Provide patients with sufficient calories, protein and vitamins by oral or intravenous route.
(3) Improve pre-operative routine inspection items: blood, urine, fecal routine; blood type, coagulation function; biochemical examination, including liver function, renal function, electrolytes, five items of hepatitis B, and four items of blood transfusion screening; ECG, Chest X-rays; Those with cardiac insufficiency or suspected cardiac organic lesions need routine cardiac color Doppler ultrasound examination. If necessary, arterial blood gas analysis and pulmonary function tests can also be performed.
(4) Preparation of gastrointestinal tract: In elective surgery, except for superficial minor surgery using local infiltration anesthesia, other fasting and drinking should be routinely performed regardless of the type of anesthesia. Fasting began 8 to 12 hours before surgery, and drinking water was prohibited 4 hours before surgery to prevent vomiting or aspiration pneumonia during surgery. For patients with gastrointestinal tract surgery, start a liquid diet within 1-2 days before surgery. Patients with pyloric obstruction should have gastric lavage before surgery. For colorectal surgery, intestinal bacteriostatic agents should be taken orally 2 to 3 days before the operation, and clean enema or colon enema should be done 1 day before the operation and early in the morning.
(5) Blood preparation: For those who undergo major or medium surgery, blood type and cross-matching tests should be performed before surgery to prepare a certain amount of whole blood or component blood.
(6) Special preparations: For patients with cerebrovascular disease, such as those with recent history of stroke, elective surgery should be postponed for at least 2 weeks, preferably 6 weeks. For patients with acute respiratory infections, elective surgery should be postponed to 1 to 2 weeks after recovery; wheezing is occurring, and elective surgery should be postponed.
(7) Fulfilling informed consent procedures: Regardless of the size, severity, and urgency of the operation, written informed consent procedures should be performed, including a surgical voluntary letter, anesthesia voluntary letter, etc., which should be signed by the patient himself or his family member.
Elective surgery indications
- Selective surgery is suitable for surgery that improves the patient's physical condition before surgery to achieve the standard of surgical treatment. The morning and evening of the surgery does not affect the treatment effect, and sufficient preoperative preparation can be performed.
- The surgical procedure varies depending on the location of the lesion, the physical condition of the patient, and the choice of surgical method.
Nursing after elective surgery
- 1. Generally, the postoperative position of the patient is placed according to the nature and location of anesthesia or surgery. Those who are not awake under general anesthesia, in order to prevent the tongue from falling and aspiration, generally take a supine position with the head to one side; spinal anesthesia and epidural anesthesia. Leakage of the needle in the inferior space can cause headache due to reduced cerebrospinal fluid pressure. After the patient is anesthetized, the patient is usually placed in a supine position.
2. To ensure the smooth recovery of patients after surgery, monitoring should be implemented according to the patient's condition. Patients with good postoperative health can use less or no complicated and invasive monitoring methods. For major difficult surgery, patients with reduced heart, lung and kidney function should be monitored after surgery. Postoperative monitoring generally includes body temperature, breathing, urine output, ECG monitoring, and arterial pressure monitoring.
3 Wound observation and care. Observe the wound for bleeding or exudation. If so, deal with it in a timely manner.
4 Encourage patients to get out of bed as early as possible to reduce complications.
Diet after elective surgery
- Normal nutrition intake should be restored as soon as possible after surgery. For most patients with non-gastrointestinal surgery and no surgical complications, normal diet should be resumed as soon as possible after surgery. However, for those patients who strictly restrict diet or absolute fasting, nutritional support should be strengthened through two methods of enteral nutrition and parenteral nutrition.