Postoperative care depends on the kind of incision used to expose the operative site: abdominal or thoracic. Surgery on the esophagus frequently involves a thoracic incision. Procedures on the esophagus are performed under general anesthesia. Frequently, a tracheostomy is performed. Immediately upon arrival to the Phase I post-anesthesia care unit (PACU), one major priority is airway management and safety. If the patient arrives to the PACU with the head of the bed flat, unless raising the head is contraindicated, the PACU RN will usually gradually and incrementally raise the head of the bed to assist the patient as he or she emerges from the anesthetic. Once the patient’s continued airway patency is ensured, the patient may be placed in a semi-Fowler’s position postoperatively to relieve tension on the suture line and to promote drainage. The semi-Fowler’s position may aid in the drainage of blood from the pleural space and prevents tension from the impinging on the suture lines. The incision is generally long and painful. Analgesics must be given in adequate doses to promote rest and adequate respiratory effort. An epidural catheter often is in place for postoperative analgesia. Patient-controlled analgesia may be used. Transcutaneous electrical nerve stimulation (TENS) may also provide incisional pain relief. A nasogastric tube will be in place and should be properly monitored. It should not be manipulated by the nurse. Chest tubes should be adequately managed. A large sterile dressing should be in place, and it should be checked frequently for drainage and reinforced as necessary. The PACU RN may mark the outline area of drainage to indicate the level as patient is received (e.g., date, time, or PACU start), thus providing a visible determination of, and the extent of, any additional drainage. Excessive bloody drainage should be reported to the surgeon (Schick & Windle, 2016).