What happens after surgery?
Your surgeon or nurse will explain what to expect after surgery. This will include the possible side effects, and how long it may take to recover from your surgery.
What to expect when you wake up after surgery
Knowing what to expect when you wake up after surgery can make you feel less anxious. It can also help to prepare your family and friends.
If you are having a general anaesthetic, your surgeon, anaesthetist or nurse will explain what to expect when you wake up after surgery. You are usually moved to the recovery room in the operating department to be monitored until you are awake. You are then moved back to the ward a short time later.
After a big operation, you may wake up in the intensive care unit or a high-dependency unit. You usually move back to the ward within a day or so. Your nurse will explain all this to you before it happens.
Feeling drowsy
You might feel drowsy at first if you had a general anaesthetic. You may feel confused, or you may not remember much about the first few hours after you wake up.
A nurse will do regular checks on you. They will check your blood pressure, so you might be aware of the machine and the cuff tightening on your arm every so often. Depending on your surgery, you may have cuffs gently squeezing your legs as well. These help prevent blood clots (DVT).
You may be given oxygen until you are fully awake. You may feel thirsty or have a dry throat or croaky voice.
Drips and tubes
When you wake up, you may have some tubes attached to your body. You can read more about what to expect in the surgery section of the type of cancer you have.
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Intravenous infusion
An intravenous infusion is when you have a drip (infusion) of fluids into your vein (intravenous or IV). The infusion is to keep you hydrated until you can eat and drink normally. Depending on your surgery, this might be for a few hours or a few days.
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Surgical drain
A surgical drain is a small, soft plastic tube placed into the wound or into your body. It drains fluid from that area and helps to reduce swelling. The tube is connected to a small bottle or bag.
The drain can usually come out in a few days. If you go home from hospital before any drains are removed, the nurses will show you how to look after it. They will also contact your local community nurses to arrange having it removed. They may give you some supplies, such as dressings, to take home for when the nurses remove the drain.
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Painkillers
You may have a cannula in your arm or the back of your hand to give you painkillers into the vein (IV). Sometimes drugs given through a cannula into a vein can be controlled by a pump.
Sometimes after big surgery, painkillers or a local anaesthetic are given through an epidural. This is a small plastic tube that goes into the epidural space in the spinal cord. The tube is attached to a small pump that delivers the drugs.
Another way to give painkillers after big surgery is through a rectus sheath catheter. This is a small, plastic tube that goes into your tummy (abdomen). It can be used to give a local anaesthetic to numb the tummy area.
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Urinary catheter
A urinary catheter is a small, flexible plastic tube put into your bladder to drain urine (pee) into a bag. It is left in until you are out of bed and moving around. For some types of surgery, such as surgery to the pelvic area, bladder or prostate, it is left in longer to give this part of your body a chance to heal.
If you are going home with a catheter still in place, the nurses will show you how to care for it and provide you with catheter bags. They will give you a contact number in case you have questions or concerns. They will also schedule an appointment for the catheter to be removed. They may refer you to the community nurse team if you need more support.
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Nasogastric tube
If you are having big surgery to your head, neck, tummy or bowel, you might have a nasogastric tube. This is a small flexible tube that goes through 1 side of your nose, past the back of your throat and down to your stomach. This will be removed as soon as possible.
Beginning to recover after surgery
There are things that can help your recovery after surgery.
Enhanced recovery programme
Some hospitals have an enhanced recovery after surgery (ERAS) programme for certain types of cancer surgery. Research has shown that enhanced recovery can reduce your hospital stay and help you recover as quickly as possible. It also aims to get you actively involved in your recovery.
Enhanced recovery starts before your surgery. We have more information about enhanced recovery.
Pain
You might worry about pain after your surgery, but any pain or discomfort can be controlled with painkillers. Your healthcare team will be keen to get you up and moving as soon as possible after surgery to help your recovery. It is important that you are comfortable to do this. Tell your nurses if you are feeling pain.
Depending on your surgery, you may only feel a bit of discomfort that can be controlled with tablets. But if you are having big surgery, you might need pain relief in the following ways.
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As an injection
Pain relief can be given as an injection into your vein (IV) through a cannula.
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Into a vein through a pump
Sometimes drugs given through a cannula into a vein can be controlled by a patient-controlled analgesia (PCA) pump. You might be given a handset to control it yourself. You press the button whenever you feel pain, and it gives you painkiller. The pump is designed so that you cannot give yourself too much of the drug.
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Around the spinal cord (epidural)
Sometimes after big surgery, painkillers or local anaesthetic are given through an epidural.
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Into the tummy area (rectus sheath catheter)
Another way to give painkillers after big surgery is through a rectus sheath catheter. It can be used to give local anaesthetic to numb the tummy area. The tube is attached to a small pump that delivers the drugs.
If you are having painkillers through an epidural or rectus sheath catheter, you may be seen by the acute pain team at the hospital. Painkillers are only given into a vein, epidural or rectus sheath catheter until you can eat and drink normally.
You will move on to tablets as you recover over the following days. You will be on tablets or oral medicines before you can go home. You may also be given oral or tablet painkillers to take home, and told how often you should take them.
We have more information about pain and painkillers.
Feeling sick (nausea)
Many people worry about feeling sick after surgery. Your nurse can give you anti-sickness (anti-emetic) injections or tablets to help prevent you from being sick (vomiting) or feeling sick. Always tell the nurses if you are feeling sick. It is important to have sickness controlled so you can eat and drink as soon as possible. This will help your recovery.
Moving around
You will be encouraged to get up and moving around as soon as possible. You may feel anxious about this, but moving around prevents complications and helps your recovery.
You can only move properly if you feel comfortable. This is why it is important that pain or sickness are controlled. If you have drips, drains or a catheter, you can still move around. The nurses can show you how to do this safely.
If you had big surgery, or have problems with your mobility, a physiotherapist or occupational therapist can provide advice and support. They help you to get back to moving and walking safely and managing activities such as getting washed and dressed.
Reducing the risk of complications
Moving around reduces the risk of complications and helps you recover more quickly. Even when you are in bed, breathing and leg exercises can help prevent these problems. Your nurse or physiotherapist will show you how to do these exercises. They may also give you written information to help guide you.
Preventing blood clots
Before surgery, the nurses will assess your risk of getting a blood clot. Your nurse may give you compression stockings to put on. Compression stockings reduce the risk of getting a blood clot in your legs. Compression socks and stockings need to be the right size with no folds or wrinkles to work effectively. Your nurse will measure you and check that they are right. They will also explain how long you will wear them for after surgery, and how to wash and care for them.
After surgery, your nurse may give you medicines to help prevent blood clots forming (anticoagulants). Usually, these are given as an injection under the skin (subcutaneously). Sometimes they may be given as tablets, but this is less common. After some types of major surgery, you may need injections for several weeks. If this is the case, the nurses can show you, or someone who looks after you, how to do them at home.
Looking after your wound at home
The wound is closed using clips, stitches or a special medical glue. Surgical clips or stitches are usually removed by a practice nurse at your GP surgery after you go home. Some surgeons use dissolving stitches that do not need to be removed. They dissolve completely when the area has healed. The nurses will tell you if you have this type.
Before you go home, the nurses will give you advice. They can:
- give you contact details for who will care for your wound after you go home, or who to call if you are worried about your wound
- explain how to keep the wound clean and give advice about baths and showers
- tell you if and when any dressings should be changed or removed
- tell you not to remove the dressing yourself – some dressings are only removed at a hospital appointment
- give you a letter for your practice nurse or district nurses.
Avoiding infection
The nurse might also ask you to check your wound or the area around the dressing, if you have to keep the dressing on. This is to check there are no signs of infection and that it is healing well. Or you may have a district nurse who will do this.
Signs of infection can include:
- heat, pain, swelling, redness or a darker change in skin colour over the wound, around the scar, or both
- fluid coming from the wound (discharge), which can smell
- a temperature above 37.5°C or above 99.5°F (a fever)
- feeling shivery and shaky
- feeling generally unwell, even with a normal temperature.
If you have any signs of infection, contact your doctor or nurse straight away on the number you have been given.
They will look at the wound and may take a wound swab to send for testing. They may prescribe antibiotics.
We have more information about avoiding infection.
Scars
Scars are likely to be:
- red if you have white skin
- a darker colour if you have black or brown skin
- firm and slightly raised
- itchy at first.
Over time, scars will flatten and fade. Everyone’s skin heals differently.
If you have any concerns about your scars, talk to your nurse or surgeon. They can check the scars are healing. If there is a problem, they can give you treatment to help.
Some people can develop keloid scars. These can develop weeks or months after surgery. Compared to the original scar, keloid scars may be:
- thicker
- more raised
- larger.
These are more common if you have black or brown skin. Sometimes keloid scars run in families.
Possible complications of surgery
Your surgeon and specialist nurses will talk to you about any possible complications of your type of surgery before you agree to have treatment.
The most common, general complications after surgery include the following:
- A wound infection.
- Bleeding – tell your nurse or doctor if you have any bleeding from your wound.
- Constipation – this means that you are not able to pass stools (poo) as often as you normally do. It can become difficult or painful. Tell your nurse if you feel like this.
- A chest infection – tell your nurse if you have a high temperature, a chesty cough with green or yellow mucus, wheezing or shortness of breath.
Some people may develop a blood clot after surgery. Tell your doctor or nurse straight away if you have pain, heat, swelling, or reddening of the skin in a leg or arm. These are signs of a deep vein thrombosis (DVT). If you have black or brown skin, the reddening can be harder to notice, but your skin may become darker.
You should also tell the doctor or nurse straight away if you:
- have shortness of breath
- have a cough
- have chest pain
- cough up blood.
These are signs of a pulmonary embolism (PE).
About our information
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer.
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References
Below is a sample of the sources used in our general surgery information. If you would like more information about the sources we use, please contact us at informationproductionteam@macmillan.org.uk
Perioperative care in adults. NICE guideline [NG180]Published: 19 August 2020 https://www.nice.org.uk/guidance/ng180/chapter/Recommendations
Venous thromboembolic diseases: diagnosis, management and thrombophilia testing. NICE guideline [NG158]Published: 26 March 2020 Last updated: 02 August 2023 https://www.nice.org.uk/guidance/ng158
Powell, R., Davies, A., Rowlinson-Groves, K. et al. (2023) Acceptability of prehabilitation for cancer surgery: a multi-perspective qualitative investigation of patient and ‘clinician’ experiences. BMC Cancer 23, 744. https://doi.org/10.1186/s12885-023-10986-0
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