The First 24-48 Hours After Surgery

Waking up: the recovery room, then the ward

You will wake in the recovery room (also called recovery or PACU), right next to theatre, with a nurse watching you closely. You may not remember the first few minutes, and that is normal. A clip on your finger checks your oxygen, a cuff checks your blood pressure, and you will likely have oxygen through a soft mask or nasal prongs for a while.

Expect to feel groggy, cold or shivery, and a little muddled as the anaesthetic wears off. Your mouth and throat may feel dry or scratchy, especially if a breathing tube was used. Once you are stable, awake and comfortable, you are moved to a ward bed (if staying in) or to a day-surgery recovery area (if going home).

Pain control — and why to ask early

Some pain after surgery is expected, but it should be controllable. The golden rule: ask for pain relief before the pain builds. It is far easier to keep pain down than to chase it once it is severe.

• Tablets or injections given regularly — tell your nurse if they are not working.
• A drip into a vein for stronger painkillers in the first hours.
• A PCA pump (patient-controlled analgesia) — a button you press to give yourself a measured dose. A built-in lockout limits how often a dose can be given, which is designed to lower the risk of overdose, and staff monitor your breathing and drowsiness. For your safety only you should press the button — never a relative or visitor — and tell staff if you feel very sleepy or short of breath.
• Sometimes a nerve block or epidural that numbs the area, which may leave part of you feeling heavy or numb for several hours.

Speak up about the type of pain too — a new, sharp or rapidly worsening pain is different from ordinary soreness and worth flagging.

Feeling sick, and the tubes you may wake up with

Nausea and vomiting are common after anaesthetic and strong painkillers. Tell staff straight away — anti-sickness medicine works well and there is no need to suffer it. Sips of water, slow breathing and lying still often help too.

Do not be alarmed by the lines and tubes attached to you. Depending on your operation you may have:

• A drip (cannula) in your hand or arm for fluids and medicines.
• Oxygen via prongs or a mask.
• One or more drains — thin tubes carrying away fluid or blood from the wound.
• A urinary catheter draining your bladder, so you do not need to get up to pass urine at first.

These come out over the next hours to days as you recover — usually sooner than you expect.

First sips, first food, first walk

Recovery moves in small steps. You will usually start with sips of water, then build up to drinks and light food once your stomach settles and there is no nausea. Do not rush eating — a queasy stomach is common early on.

Getting moving matters more than almost anything else. A nurse or physiotherapist will help you sit up, then stand, then take your first few steps, often the same day or the next morning. Early walking lowers your risk of blood clots in the legs and lungs, helps your lungs and bowels recover, and speeds you home. Move your ankles and take deep breaths even while still in bed.

If you have a catheter, it will be removed once you are mobile — after which you need to pass urine yourself. Being unable to pee within a few hours of the catheter coming out is worth telling staff about.

Day-case versus staying overnight

If you are a day case, you go home the same day once you are awake, comfortable, eating and drinking, able to pass urine, and have a responsible adult to take you home and stay with you. You must not drive, sign legal documents, operate machinery or be alone for 24 hours after a general anaesthetic or sedation — arrange your ride home after surgery in advance.

If you are staying in, the first night is about rest, pain control, and the nurses checking your wound, drains and observations regularly — including overnight, so expect to be woken. Either way, the broad path of healing is the same; see our wider guide to recovery after surgery for the days and weeks ahead.