What Is Preoperative Fasting?

The perioperative period is a whole process surrounding the operation, from the patient's decision to undergo surgical treatment to the surgical treatment until basic rehabilitation, including a period of time before, during and after the operation, specifically from the time when the surgical treatment is determined until Until the end of the treatment related to this operation, the time is about 5-7 days before surgery to 7-12 days after surgery.

Perioperative period

The perioperative period is a whole process surrounding the operation, from the patient's decision to undergo surgical treatment to the surgical treatment until basic rehabilitation, including a period of time before, during and after the operation, specifically from the time when the surgical treatment is determined until Until the end of the treatment related to this operation, the time is about 5-7 days before surgery to 7-12 days after surgery.

Chinese name

Perioperative period

Foreign name

Peri operation period

End Time

5-7 days before surgery to 7-12 days after surgery

Time

Before, during and after surgery

Explanation

A whole process around surgery

Ready

Psychological preparation and patient physical preparation

The general perioperative preparation mainly includes psychological preparation and patient physical preparation.

1. Psychological preparation (including medical staff)

(1) Promote communication with patients and their families, the patient's condition, diagnosis, surgical methods, the necessity of surgery, the effect of surgery, the possible complications and preventive measures, the danger of surgery, the recovery process after surgery, and After healed, explain clearly to the patients and their families, so as to gain trust and cooperation and make the patients happily undergo the operation.

(2) The choice of patients' full autonomy should be fully respected. Diagnostic and therapeutic measures should be taken on the premise of the patient's "informed consent". Before the patient does not have the informed consent, it is not appropriate to perform any surgery or injury treatment.

2. Physiological preparation: The patient maintains a good physiological state to safely pass the operation and the post-operative process.

(1) Pre-operative training: urinate on bed, cough and sputum method, stop smoking two weeks before operation.

(2) Prepare blood and rehydration: correct water, electrolyte acid-base imbalance and anemia; blood type identification and cross-matching test, prepare a certain amount of whole blood.

(3) Prevention of infection: Do not contact with infected patients;

(I) Evaluation and care of patients before surgery

1. Nursing focus before the operation

(1) Assess and correct physical and psychological problems that may increase the risk of surgery, and help patients to do good psychological and physical care.

(2) Provide patients and family members with health instructions regarding surgery.

(3) Help to formulate adjustment plans for discharge and lifestyle changes.

2. Evaluation of patients before surgery

(1) General information.

(2) Past history and health status.

(3) Evaluation of the patient's psychological condition.

(4) Ask your relatives whether they support the surgery, their degree of concern, and their affordability.

(5) Assess the patient's tolerance to surgery, laboratory test results, and important organ functions.

3. Pre-operative patient care measures

(1) Psychological preparation: The significance of psychological preparation before surgery is to reduce anxiety; promote the stability of pulse and blood pressure after surgery; reduce the amount of anesthetic during surgery, reduce the need for analgesics for patients after surgery; ; Reduce the incidence of postoperative infection; shorten the length of hospital stay. The most basic measures of psychological care: face up to the patient's emotional response, encourage patients to express their anxiety, feelings or questions, and provide support and counseling.

Common psychological problems of preoperative patients: exaggerating the danger of surgery; not understanding the process of anesthesia; not knowing the degree of pain; pessimistic about the prognosis. The most effective way to solve these problems is to eliminate the "unknown" and enhance the patient's sense of control. Preoperative education and arrangement of patients for recreational activities can achieve better results.

(2) Environmental preparation: The temperature of the ward should be maintained at 18 ° C-20 ° C, and the humidity should be 50% -60% to reduce escort. For newly admitted patients, the nurse will introduce the ward environment.

(3) Physical preparation: help patients complete various examinations, nurses explain the significance of each examination to patients, and help and urge patients to undergo examinations. For the blood, urine, and stool tests of the sample, the patient should be informed of the requirements for the collection of various specimens.

Skin preparation: Removes microorganisms from the skin and reduces the chance of infection causing the wound not to heal. Skin preparation is usually performed the day before surgery. The patient cleans the skin, trims the fingernails, and

Explanation

The perioperative accidental hypothermia (IPH, Inadvertent PerioperativeHypothermia) refers to the core body temperature below 36 ° C. The core body temperature 34 ° -36 ° C is clinically referred to as mild hypothermia. ^[1] On average, patients' core body temperature drops by 1-3 ° C during surgery. Accidental hypothermia during the perioperative period is a common and preventable complication in anesthesia and surgery, with a incidence of up to 50% -90%. Accidental hypothermia during the perioperative period can cause serious consequences, causing additional trauma and financial loss to the patient.

Perioperative unexpected hypothermia complications

Perioperative hypothermia has many adverse effects on the body. A large number of clinical studies have confirmed that ^[2] even mild hypothermia can lead to many serious consequences.

For example, the incidence of surgical site infection, which is widely mentioned in the study, has increased three times. The reasons for this include three aspects: the surgical incision exposes the body to exogenous and endogenous pathogens during surgery, and The main defense is achieved by oxidative killing of neutrophils.

1. Low body temperature triggers vasoconstriction, reduces the amount of oxygenation and perfusion of the tissue, reduces the number of neutrophils reaching the surgical incision and the production of superoxide free radicals;

2. Low temperature induced a decrease in the levels of various anti-inflammatory cytokines and interleukins;

3. Mild hypothermia increases nitrogen loss and reduces collagen production, slowing wound healing; therefore, a series of factors combined lead to a 3-fold increase in the risk of surgical site infections (SSIs). Other perioperative unexpected hypothermia complications include increased myocardial ischemia and cardiac dysfunction, increased blood transfusion and infusion, prolonged drug metabolism time, prolonged disease recovery period, and discomfort from chills and fever. Severe hypothermia can also cause immune dysfunction, ^[3] coagulation abnormalities, ventricular fibrillation, respiratory depression, electrolyte and acid-base balance disorders, and increased mortality, directly threatening the treatment effect and life safety of patients.

In addition, patients often complain that cold discomfort in the early postoperative period is one of the most painful experiences during hospitalization, sometimes even more than pain. Once a series of hypothermia complications occur, it will inevitably lead to increased clinical treatment costs, such as the cost of treating myocardial infarction, surgical site infection, increased blood transfusion, ventilator use, and ICU indwelling time, etc. Studies show that maintaining normal surgery Body temperature can save up to $ 2,500- $ 7,000 in medical expenses per capita. Therefore, early detection and timely correction of accidental hypothermia during the operation can not only reduce the many complications of perioperative hypothermia, greatly reduce the cost of treatment, but also increase patient comfort and reduce the incidence of bedsores. Its clinical application value is self-evident. .