Surgical Services

The Day of Your Surgery

Adult and pediatric surgeries are performed in the George N. Pappas, MD Surgical Pavilion by highly qualified surgeons who are on staff at Phelps. Our dedicated, skilled nursing staff is here to care for you every step of the way. We realize that having surgery is stressful. If at any time you have questions or concerns, please share them with us.

You and your surgeon have decided that surgery is appropriate treatment for your condition. You will be admitted to the hospital either through the Ambulatory Surgery Unit (ASU), the Emergency Department (ED/ER), or one of the patient care units.

All efforts are made to keep to the scheduled time of your surgery. However, emergencies or cancellations may arise that affect this time. If your surgery is going to be delayed or performed earlier, you will be notified as soon as that change occurs.

Prior to surgery, you will meet your anesthesiologist. Anesthesia services at Phelps Memorial Hospital Center are provided by Westchester Anesthesiologists, PC. They are board certified by the American Board of Anesthesiology. The primary role of your anesthesiologist is to ensure your safety and comfort in the “peri-operative period” – the time just before, during, and immediately after your surgery. He or she will discuss with you your medical history and your scheduled surgery. Your anesthesia options and pain management plan will be reviewed with you.

Just prior to surgery, you will be taken to the OR holding area. There a registered nurse from the operating room will review and verify with you and your physicians the information in your chart. Your surgeon will inform you of the approximate amount of time your surgery will take.
When you are taken into the operating room, you will be connected to monitors and positioned for safety and comfort.

There is a waiting room on the third floor outside the surgical suite where your family and friends can wait. When your surgery is finished, your surgeon will go to speak to those who are waiting.

After surgery, most patients are taken to the Post Anesthesia Care Unit (PACU), formerly called the Recovery Room. You will continue to be monitored there and receive oxygen and IV fluids while you wake up. You may experience dry mouth, a sore throat or blurry vision. These are normal and will subside. You will be given warm blankets for comfort.

The nurse will ask you to rate your pain on a scale of “0 to 10”. Zero is equal to “no pain” and ten is equal to the most “severe pain.” You will be shown a pain chart. Reporting your pain as a number helps the nurses and doctors know how well your treatment is working and whether to make any changes.

Your doctor may order tests such as x-rays, EKG, or blood tests to be done in the PACU. Your length of stay in the PACU will be based on your individual needs. This time can range from 30 minutes to several hours. The doctors and nurses will discharge you from the PACU only when you are stable and appropriate pain management is achieved.

Visiting is limited in the PACU. This is an important time for you to rest and recover from anesthesia. Special considerations will be made for pediatric patients. Parents will be taken into the PACU as soon as possible. We realize that when a child has surgery there are special needs to be met. When you are discharged from the PACU, you will go to the ASU or one of the patient care units. Family and friends may join you at that time.

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Pain Management

Pain Management
People used to think that severe pain after surgery was something they “just had to put up with.” Today, you can work with your nurses and doctors before and after surgery to prevent or relieve pain. They will help you understand why pain control is important for recovery as well as for your comfort. You can play an active role in choosing options for treating your pain.

“Pain” includes burning or discomfort that interferes with activities of daily living.

Managing Pain After Surgery

• Enjoy greater comfort while you heal.
• Get well faster. With less pain, you can start walking, do your breathing exercises, and regain your strength more quickly.
• Improve your results. People whose pain is well controlled seem to do better after surgery. They may avoid some problems (such as pneumonia and blood clots) that may affect others.

Non-Drug Pain Relief Methods
These methods can be effective for mild to moderate pain and can help to boost the pain-relief effects of drugs.

• Patient Teaching: Learning about the operation and what to expect can reduce anxiety.
• Relaxation: Simple techniques can help to increase comfort.
• Music: Music can provide relaxation and distraction.
• Physical Agents: Heat or cold therapy, massage, rest, and good body alignment may help to lessen pain.

Pain Relief Medicines

• Analgesics and Anti-Inflammatory Drugs: Acetaminophen, aspirin, ibuprofen, and others may help to reduce swelling and soreness. These medicines may be combined with others for improved pain control.
• Opioids: Morphine, codeine, and other opioids are most often used for acute pain such as short-term pain after surgery. These medicines are effective for severe pain and may cause drowsiness, nausea, or constipation.
• Local Anesthetics: These medicines (bupivacaine, for example) are given during some types of surgery, either near the incision or through a small tube in your back, to block the nerves that transmit pain signals. There is little risk of drowsiness or constipation from a local anesthetic, and it may reduce the need for opioid use.

Pain Relief Methods

• Tablets or Liquid: Medicines given by mouth cause less discomfort than injections and can work just as well. They are inexpensive, simple to give, and easy to use at home. These medicines cannot be used if you are nauseated or vomiting.
• Injections into skin or muscle: Medicine injected into the skin or muscle is effective even if you are nauseated or vomiting. The medicine may cause discomfort at the injection site for a brief period of time.
• Injections into the vein: Pain relief medicines are injected into a vein through an intravenous catheter. Medicines given into the vein act quickly. Patient Controlled Analgesia or P.C.A. is a method of pain control that allows you to control your own pain medicine within pre-set limits established by the physician. A P.C.A. machine is used to set and administer doses of medicine. A push button control is given to you to be pressed when a dose of medicine is needed. A more detailed description of P.C.A. can be obtained from your nurse.
• Injections into the spine: Pain relief medicines (opioids) are given through a small tube or injection in your back. This works well when you have chest surgery or surgery on the lower parts of your body. Some patients remain pain-free for hours. Nurses watch you closely for the first twenty-four hours for problems that can appear hours after the medicine is given.

How to Keep Your Pain Under Control

Ask the Doctor or Nurse What to Expect.

• Will there be much pain after surgery?
• Where will it occur and for how long?

Being prepared helps put you in control.

Discuss the Pain Control Options.

• Talk with your nurses and doctors about pain control options that have worked for you in the past.
• Tell your doctors and nurses about any drug allergies you have.
• Ask about side effects.

Talk About the Schedule for Pain Medicines in the Hospital.

• Some people get pain medicines only upon request.
• Giving pain medicines at set times instead of waiting until the pain breaks through seems to give better results.
• Patient Controlled Analgesia can let you control when you get pain medicine.

Take (or ask for) Pain Relief Drugs When the Pain First Begins.

• Take action as soon as the pain starts.
• If you know your pain will worsen when you start working or doing exercises, take the pain medicine first. It is more difficult to treat once the pain has taken hold. This is a key step in proper pain control.

Help Doctors and Nurses “Measure” Your Pain.

• You will be asked to rate your pain on a scale of 0 to 10. Zero is equal to “no pain,” and 10 is equal to “the most severe pain.”
• You may also set a pain control goal, such as having no pain that is worse than 2 on the scale.
• Reporting your pain as a number helps the doctors and nurses know how well your treatment is working and whether to make any changes.

Tell the Doctor or Nurse About Any Pain that Will Not Go Away.

• Don’t worry about being a “bother.”
• Pain can be a sign of problems with your operation.
• The nurses and doctors want and need to know if you are experiencing pain.

For more information about surgical pain management, please call your physician or contact Pre-Surgical Assessment at Phelps: (914) 366-3792 (Mon-Fri, 8 a.m. – 4 p.m.)

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