The operating room, known as the safest place in the hospital. Every day, several types of anesthesia are performed here.
Why the safest? Because the operating room has very advanced equipment. Most importantly, the operating room has an anesthesiologist who is responsible for maintaining the safety of patients all year round.
However, with seemingly safe operations, unexpected situations can happen at any time.
A few months ago, the health care policy was reformed. The overall direction is that there is a price limit for each disease.
That is, the reimbursement for each operation is fixed. If you overspend, Medicare doesn’t care. The extra part can only be solved by the hospital itself.
The general direction has come out, and all departments are complaining.
However, clinical work must continue, and patients must be seen.
In order to control costs, some advanced monitoring facilities or drugs that were not considered before have been used with caution. Unless the patient’s condition is complicated, attention is paid to controlling costs.
Some people say that doctors think about price all day long, is that right?
No way. If you overspend, fines and talks are inevitable.
Returning to the hard days of the past, everyone groaned. Fortunately, they all came from that time, and they all adapted quickly. However, risks are also brewing unknowingly.
On that day, a colon operation that seemed to have no risk caused Dr. Liu, who was in charge of anesthesia, to consume a lot of brain cells.
The patient is in his 60s, male, and appears to be a perennial worker.
After entering the operating room, monitor various vital signs.
As soon as there is no abnormality, start anesthesia.
However, just during intubation, the patient’s blood pressure became severely abnormal.
The alert Dr. Liu immediately kept an eye on the monitor, hoping to find out the reason from the changes in various data.
At this time, the first thing he suspected was a cardiac event. Simple changes in blood pressure are not terrible, just fear of heart problems. At the very least, when the laryngoscope is lifted, the most likely occurrence is a drop in heart rate caused by the vagal reflex.
However, the heart rate did not drop, but increased. This means that the vagus reflex can be ruled out. So, what is the reason?
The intubation action cannot be stopped, and the endotracheal tube is inserted while thinking.
While applying the tape, Dr. Liu noticed that the patient’s chest was obviously red. His tanned complexion seemed to turn red.
Combined with severely abnormal blood pressure, he immediately remembered the complication of histamine release.
Although this complication has not appeared for a long time, various anesthesia accidents or complications have been carved into the brain of every anesthesiologist.
Since the use of cisbenzene, a good muscle relaxant, except for very few patients or due to the rapid drug push, histamine release has rarely occurred again. Even if it is suspected to occur, there is generally no obvious cyclic change.
At this point, Dr. Liu was almost certain that histamine release had occurred. So, immediately push the drug to fight.
Also, even without the release of histamine, the anesthesiologist may not allow the patient’s blood pressure to continue to drop. At the very least, to reverse the seriously abnormal indicators, and to find out the real cause.
Fortunately, the patient’s blood pressure stabilized after two doses.
Another big risk of histamine release is bronchospasm. Relative to the drop in blood pressure, the consequences of this risk are not at all small, or even more serious.
Bronchospasm may result from histamine release in patients with previous chronic lung problems or recent acute respiratory problems.
Severe hypoxemia may occur when it occurs. If left untreated, the circulatory system may also become increasingly disorganized as the respiratory system interleaves.
On-stage surgery has already begun, and Dr. Liu, who is busy, is lost in thought. Among them, there is a little bit of self-blame: if the drug push is slower, maybe the incidence rate may be lower?
[Warm reminder] Please pay attention, here are a lot of professional medical science, to reveal the secrets of surgical anesthesia for you~