There was an appendicitis in the operating room on Sunday. Suddenly, I received another notice of appendicitis. Xiao Li, who was under anesthesia, complained in his heart: What day, so many appendicitis?
Complaining is complaining, work has to be done.
Li originally thought Sunday would be a very good class, but this class made her miscalculate.
Operation on Sunday means no rest for the week ahead. Including the previous week, her record of continuous anesthesia will reach half a month.
In order to buy herself a little more time on the weekend, she quickly adjusted the anesthesia plan and set off for anesthesia to wake up quickly: the inhalation anesthetic that had been prescribed 2 was adjusted by her. small. Worried that the depth of anesthesia was not enough, she injected an intravenous anesthetic through an intravenous pump.
Speaking of this intravenous drug, it is not normal. In the anesthesia industry, it is affectionately called “milk”. Due to its short metabolic half-life, it does not accumulate when used in small amounts, and is loved by everyone. But if it is a major surgery, many doctors will choose another inhalation anesthetic. The inhaled anesthetic used by Xiao Li is more controllable in major operations than “milk”. Since this appendicitis was a minor operation, Xiao Li also replaced it without hesitation.
It was time for the surgeon to close the abdomen, and Xiao Li quickly stopped all the inhaled anesthetics. Normally, it’s less than 10 minutes away from the end.
However, it was said that the abdomen would be closed, but the surgeon was slow to close the abdomen. As if I had never seen such a beautiful abdominal cavity, I kept looking at it over and over again.
Just because of this delay, 10 minutes have passed.
At this time, Xiao Li may feel that the anesthesia may be shallow. Looking at the incision, which was only a few centimeters, she manually pushed some analgesics that were still being pumped. After that, worried that the anesthesia was not enough, the speed of the pump was increased again.
The surgeon is finally about to close his abdomen, and Xiao Li’s anxious heart finally calms down a little.
As soon as the doctor placed the stitches, the patient’s abdomen moved. Xiao Li comforted the surgeon and said: “It’s okay, the patient’s breathing is coming back soon, the patient is not in pain, just sew it up. So, some more painkillers were pushed.
In the past, breathing back and stitching a few stitches during exercise were common, so the surgeon didn’t care. However, after Yu Guang felt Xiao Li’s vicious eyes, they didn’t dare to delay any longer. After all, if they did not close their abdomens quickly after the operation, it would affect the control of the anesthesia.
After 10 minutes, the surgery finally finished the last stitch.
Seeing that the surgical stitches were finished, Xiao Li quickly turned off the pain reliever.
They all said that this analgesic was good, and it didn’t disappoint her. Theoretically, the metabolic time does not exceed 6 minutes. At this time, the patient opens his eyes in only 3 minutes.
Patients are also able to blink in response to Xiao Li’s instructions.
Seeing this, Xiao Li thought it was all right, so he pulled out the tracheal tube.
However, after pulling out the tracheal tube, she found that she couldn’t hold her breath at all. For a while, she thought it was an airway obstruction.
Just after she turned around and took the suction tube back, it was impossible to break apart the patient to suck the sputum. At this time, the patient would not open his eyes no matter how he called. Looking at the patient again, the two upper arms tightly clamped the torso on both sides, the edge of the pectoralis major muscle was obviously stretched, the trismus was closed, and even the head could not be moved. Shake the patient’s head a little, and the whole body follows. This shows a problem, the patient’s entire body is in a state of muscle rigidity.
The moment she saw this state, she already knew what was going on. However, what she didn’t expect was that muscle rigidity caused by opioids generally occurred in the pre-anesthesia period, and I had never seen one during the recovery period.
Being too late to regret, she quickly pushed on for a little sedative and a little muscle relaxant.
That’s it, Because of the muscle relaxation, I couldn’t get out within half an hour.
She was depressed all day after the patient was taken out of the operating room. Deep in my heart, I deeply realize that anesthesia cannot be too hasty!
【Knowledge point】Opioid-induced muscle rigidity is mainly manifested as muscle rigidity immediately after the patient begins to lose consciousness or loses consciousness. Mild muscle rigidity may also occur when the patient is awake, such as hoarseness. In severe cases, the abrupt closure of the glottis results in the obstruction of ventilation of the respiratory sac, mask and laryngeal mask, ETCO2 waveform when there is no ventilation, thoracoabdominal muscle stiffness when palpating the chest and abdomen, and a rapid drop in SpO2.