Surgery

What happens after surgery?

After Surgery, people often wonder whether they can function normally and what will happen to them. As well as the physical and emotional stress that comes with surgery, you may need support from family and friends when recovering from anaesthesia side effects. For example, someone might drive you home from the hospital. Below is a guide to what to expect after surgery, so you and your family can be prepared.

What Happens in the Recovery Room?

After surgery you will be moved to a recovery room. This is an area near the operating theatre with monitoring equipment and specially trained staff, who will monitor you as the anaesthetic wears off.

While you are in the recovery area the nurses might regularly check the following:

Your blood pressure, pulse and breathing rate
Your wound for any bleeding
That you are comfortable, and any pain is under control
How much fluid is draining from your wound drains
That any drips into the bloodstream are running at the right rate

People who need a high level of care will go into the high dependency unit (HDU) or intensive care unit (ICU). You will be moved out of the HDU or ICU as your condition improves. Your doctor will tell you before surgery if it’s likely you will be moved to one of these units.

Once you have recovered enough from the anaesthetic you go back to the ward. It's quite common for people not to remember being in the recovery area.

What is a Surgical Drain?

You may wake up with some tubes attached to your body. If you had a small operation, you may not have any. Or you may only have 1 or 2 tubes. But after bigger operations you may have the following:

Intravenous (IV) Drip	Inserted into a vein in your arm or hand to give you fluids until you can eat and drink again. Also used to give pain relief and other medicines. This can be in place for a few hours or a few days, depending on the surgery.
Tube Down your Throat	Used to help you breathe during surgery. This is usually removed while you are under anaesthetic, but may stay in if you go to HDU or ICU.
Surgical Drain	A tube placed in the wound to drain excess fluid into a small bottle or bag. Usually removed after a few days, depending on how much fluid is being collected and the type of operation.
Urinary Catheter	A thin tube that drains urine from your bladder into a bag. This is usually removed when you start walking after surgery and can get to the toilet, or when your epidural pain relief is finished.
Nasogastric (NG) Tube	A thin tube placed through your nose into the stomach, which removes fluid from the stomach until bowel function returns to normal.
Feeding Tube	This may be needed if you are unable to eat and drink after surgery. A tube is placed into your stomach or small bowel, either through your nostril or through an opening on the outside of your abdomen. This is usually temporary, but sometimes permanent.

Your health care team will give you specific directions for your recovery, such as how to care for any wounds, what foods or activities to avoid, and what medications to take.

The Side Effects of General Anaesthesia

Most side effects occur immediately after surgery and don’t last long. Tell your medical team if any of these side effects get worse or worry you.

Nausea and vomiting	This can happen within 24 hours of surgery, but there are some medicines that can control these side effects. Some people continue to feel nauseous for the first few days after they are discharged from hospital but this will improve.
Chills and dizziness	Your body may cool down after surgery, so you could feel cold and shiver. During surgery and recovery, your temperature will be maintained, usually with warm blankets. Some people feel dizzy from the anaesthetic or because they may be dehydrated. You will be monitored to make sure you aren’t getting an infection.
Agitation	You might cry or feel restless and anxious when you wake up. Some people feel like their arms or legs are twitchy. This is a normal reaction.
Sore throat or hoarseness	The tube put in your throat to help you breathe during surgery can leave you with a sore throat or a hoarse voice after the tube is removed. This should get better in a few days.
Mental effects	You may feel confused, groggy or “fuzzy” in the minutes or hours after you wake up, and you may not remember why you had surgery. Most people make a full recovery within a few hours. In some cases, this may take days, particularly in elderly people and those who had memory problems before surgery. Rarely, people have ongoing mental effects (such as fogginess or mild memory loss) for a week or several months after surgery. This is called postoperative cognitive dysfunction. The reasons for this are unknown. (Read our cognitive changes blogs for more help - Cognitive Changes )

How to Control Pain after surgery

You may experience pain after your surgery, which can be controlled by painkillers. The type of pain control you need will depend on the operation you have. If you have a small operation, you may only need tablets afterwards to control the pain, but for some people may need the following:

As an injection - You can have painkillers as an injection under the skin (subcutaneous), into a muscle or directly into a vein (intravenous).
Into a vein through a pump - Sometimes, you can control the pump using a handset, which allows you to press a button when you need more painkillers. You can use it as much as you want, as it is designed so that you cannot give yourself too much.
Epidural - You might have a continuous dose of painkiller into the spinal fluid through a fine tube and a pump.

Managing pain is important to help you move about soon after surgery, and to make sure you can take deep breaths. This helps to reduce some possible complications of surgery. If your painkillers are not working well for you, tell your nurses.

What complications may occur after surgery?

Most are unlikely to happen but the more complex the surgery is, the higher chance of problems. Most complications are minor and can be treated easily, but some can have serious consequences.

Infections	The biggest risk of infection after surgery is at the wound site, but infection can also occur in the chest, in the urine, and around the catheter site.
Bleeding	Internal bleeding can occur if a blood vessel breaks free after surgery, or external bleeding can occur if a wound opens up.
Lung Problems	After surgery, it may be painful to breathe or cough for a period of time, particularly if you have had surgery to your chest or abdomen. A physiotherapist will teach you breathing or coughing exercises to help keep your lungs clear and reduce the risk of a chest infection.
Blood Clots	This can be caused by laying down for too long, so the nurses may encourage you to move around, teach you leg exercises or you may wear compression stockings while in bed. For some people you might be given an injection just under the skin to lower the risk of blood clots. After some types of operations, you might carry on having these injections for 4 weeks. Before you go home, your nurse will teach you to do these injections yourself. Or a district nurse might come to your house to do them.

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