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THE PATIENT'S PREPARATION BEFORE THE CARDIAC SURGERY

- Before the entry into the operating theatre
- Installation in the operating theatre
- Implanting the different resuscitation anaesthesia devices

Implanting the different resuscitation anaesthesia devices

Once the patient is anaesthetized, the anaesthetist implants different devices measuring the clinical parameters; he also chooses a central venous area.

A hose is placed in an artery, as a rule the radial artery (one of the arteries localized just above the wrist). This device will be linked to an electronic device measuring blood pressure; its main interest is to control BP non-stop during surgery.

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An infusion is settled in a big calibre vein, a central vein. Several central veins can be used: the subclavian veins, localized under the clavicle, the internal jugular vein, localized at the neck level and the femoral vein localized at the fold of the groin level. The internal jugular vein is generally chosen.

A probe is placed in the stomach (a gastric probe) so as to suck in all secretions produced by the stomach during surgery, which avoids the passage of these secretions into the lungs.

A probe is implanted in the urinary duct to collect all urines. The interest of this probe is mixed: it avoids urines to spill on the operating table and permits to quantify the volume of urines emitted.

A small rectal probe is inserted to measure the central temperature.

In some cases, a probe permitting to measure the pulmonary pressures and the systolic output (Swan-Ganz’ probe) is introduced through a central venous area (infusion in a deep vein).

After having inserted these different devices, the patient is painted with an antiseptic solution on the sternum, the abdomen and the lower limbs in case of a bypass surgery.

Then, the operation areas are laid and the different instruments necessary to the surgery are installed.

The time necessary between the entry into the operating theatre and the first incision is about 1 hour.

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File last reviewed on dec 18, 2011