What are the main discomforts in the early days after bypass surgery?

  Bypass surgery requires general anesthesia, tracheal intubation and chest opening, which is traumatic to the body. The following conditions are more common after bypass surgery.  1. Pain: Pain at the incision site is the most common and can be understood by ordinary patients. However, the pain of the chest incision may cause the patient to be afraid of deep breathing and coughing after the surgery, causing complications such as pulmonary atelectasis, lung infection, and pleural effusion. Most patients can get through this difficulty with patient explanation and encouragement. Individual patients need sedation and analgesics, but in principle, they should be used as little as possible. Chest incision pain usually gradually improves after 4-5 days postoperatively. There is another kind of chest pain is more common such as left chest, both shoulders and even back, the performance of each patient is different, doctors need to distinguish it from angina pectoris, at the same time, patients who undergo surgery are mostly of advanced age, thoracic injury caused by osteoporosis and becoming brittle, generally the pain is not too intense, patients with strong pain tolerance can be left alone, individual patients need to take analgesics.  2, numbness: numbness of the left chest and the limb of the collected blood vessels is more common. It is mostly caused by surgery. When collecting the internal mammary artery, the free trauma may easily lead to nerve damage in the chest wall. In addition, the collection of graft vessels in the extremities may injure the superficial dermal nerve, causing local skin numbness as much as possible, such as damage to the dermal nerve when taking the radial artery can cause numbness in the palm of the hand in the area between the big fish after surgery, taking the lower extremity venous vessels can cause skin numbness in the corresponding area, but this numbness generally does not need to be dealt with, and the patient is instructed to strengthen the corresponding exercise that.  3, swelling: mostly refers to the edema caused by the lower limb after taking the blood vessel. The swelling of the limb needs to draw the attention of the physician to identify the nature of the lesion and exclude the causes of deep vein thrombosis and heart failure. It is usually common in the limb from which the vessel was taken and is caused by postoperative tissue edema, mostly mild swelling. Individually, the distal blood supply is affected due to poor hemostasis during suturing and massive accumulation of blood in the intermuscular space, which requires close observation and prompt treatment. Most patients with mild edema will improve within one to three months, while individual patients with swelling of the affected limb may extend for several months or more than a year. Elevating the lower limb more often or wearing elastic stockings can help reduce edema, and in recent years, our center has applied cavernoscopy to obtain the saphenous vein, and few patients will have lower limb edema after surgery.  4. Cough: There are active and passive coughs after surgery. Physicians recommend that patients should actively cough in the early postoperative period to enable early recovery of lung function and improve the oxygenation status of the body. Passive coughing needs the attention of physicians to distinguish whether it is due to cardiac insufficiency, lung infection, or pulmonary atelectasis or pleural effusion. In the early postoperative period, patients often experience thirst due to restriction of crystal intake and diuresis. Pulmonary infections are more common in patients who are elderly, bedridden, and smokers, and require adequate preoperative respiratory preparation and early postoperative strengthening of respiratory management with sensitive antibiotics. The incidence of pulmonary atelectasis and pleural effusion is higher. In addition to the above-mentioned reasons, the fear of coughing, sticky sputum that cannot be easily coughed out, low activity, poor chest drainage and more exudation are all causes of pulmonary atelectasis and pleural effusion, which need to be diagnosed and treated as early as possible.  5, easy fatigue: bypass surgery has a certain trauma to the body, the body needs a certain amount of time to fully recover, which is the normal response of the body, in order to prevent complications and promote the early recovery of the body, in general, clinicians recommend that patients get out of bed early, early activity. However, the decision should be based on the patient’s age, pre-surgical status, and cardiac function. Activities need to be individualized and gradual, and rest is needed when feeling fatigued. Do not accidentally increase the activity level blindly. If there is no other influence, the fatigue will gradually disappear with the recovery of physical strength and the increase of activity after proper exercise.  6, other: more common are sleep disorders, poor appetite, etc., generally after adjustment, should be able to return to normal in a relatively short period of time.  7.Abnormalities in mental behavior: Some patients will have abnormalities in mental behavior after surgery, some are related to cerebral vascular sclerosis, some are related to carotid plaque, some are related to the effect of surgery on the patient, and some are related to the patient’s mental behavior ability. Therefore, certain factors can be prevented. Before the surgery, we should do a good job of thinking about the patient, we should let the patient reduce the pressure of thinking, and after the surgery, we should also do the work of decompression, relax, communicate more with the patient and put down the burden, which is beneficial to the early recovery of the patient.