What happens in the first 24 hours after CABG surgery?
After your coronary artery bypass graft (CABG) surgery is finished,
you will be transferred to a cardiac intensive care unit (CICU) or surgical ICU
so that specially trained hospital staff can monitor your condition. Since the
recovery process is different for every patient, the amount of time you spend
in the specialized ward will vary.
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When your need for monitoring decreases, you will be transferred to a
step-down unit in the hospital in preparation for your return home.
During your recovery from bypass surgery, you will hear one universal
theme: Everyone heals at a different pace. Your experience may vary from the
typical course discussed below.
Immediately after your surgery
Since general anesthesia is used during the CABG procedure, you may
be unconscious for several hours after surgery. Exactly when you wake up
depends on a number of factors. For example, additional medications to control
complications during or after your surgery may keep you unconscious longer.
While you are still unconscious, you will probably be taken to the
intensive care unit, a special ward reserved for people who have just undergone
significant surgeries. People usually remain in this unit for 1 to 3 days. A
longer stay does not mean that your CABG surgery was not successful. It may
mean, for example, that it is taking more time for your anesthesia to wear off
or for fluid within your chest to drain.
As you wake up, you may notice several sensations. You will probably
feel very groggy. Anesthesia can make you feel nauseated, so your stomach may
feel queasy. You may also notice immediately that you cannot swallow or speak
because of the tube placed in your throat to help you breathe. You may also
hear a lot of noise, since the equipment and monitors used in most intensive
care wards can make a lot of beeping noises.
Although the effects of anesthesia usually help with the discomfort
from CABG surgery, you still may experience some pain after you are awake. To
relieve this discomfort, your nurse will give you pain medication through your
intravenous (IV) line directly after surgery.
When you become more alert, your doctor will prescribe pain
medication. You may have a small machine that allows you to control when and
how much pain medication you get, although this is more common after 24 to 48
hours. This machine (a PCA pump) has a device that you hold in your hand with a
button to press to start medication flowing through your IV line.
Getting out of the intensive care unit
When your condition has improved, you will be transferred from the
specialized ward to a normal cardiac care unit, sometimes called a step-down
unit. Most hospital step-down units have significantly fewer nurses and
monitoring personnel, so you are usually transferred there when:
Your breathing tube has been
You are able to take medications
Invasive tubes and monitoring requirements are