Sunday, a short holiday. Dr. Li, who had a rare rest, was sleeping late at home.
Suddenly, Dr. Shen, a general surgeon, called. As soon as it was his number, he knew that there must be nothing good. In particular, a bowel surgery in their department was just anesthetized on Friday afternoon. Not sure, what is wrong with the patient.
It can be said that anesthesiologists worry about the safety of every operation. In addition to the full protection during the operation, the postoperative care has also been concerned. Until when the patient is discharged home “in good condition”, the stone in his heart will not fall to the ground.
I was afraid of what to expect. Sure enough, this patient had some problems after surgery. To be precise, it is a very difficult problem. Dr. Shen described: On the first day after the operation, the patient was normal because of the sedation in the ICU. But on Sunday, the day after the surgery, the patient suddenly became a different person. Not only was the man very unfamiliar, but he seemed to have lost his mind. He didn’t care about the knife on his stomach. Even the drainage tube was pulled open by him.
Everyone would be worried to hear him describe it like that. So, Dr. Li rushed to the hospital as quickly as possible.
When he arrived at the hospital, he was also taken aback: from a distance, the doctors, nurses and family members in the ward were all on one side. And this patient, holding a mop in his hand, stood vigilantly at the corner of the wall, with the aura of “one husband is the one who is in charge, and ten thousand people are not allowed to open it”.
On closer inspection, it was incredible: the disconnected drainage tube was just dangling around his waist, and there was no trace of the drainage bag at all.
After a few shouts, the old man doesn’t seem to know anyone. Even when his son called him, he was just startled, and didn’t recognize the sign that it was his own son. However, the muttered words in his mouth showed that he was conscious and had some logic. For example, when it comes to saying who wants to harm him, the name is clearly stated.
In this situation, Dr. Li quickly determined that the patient had postoperative cognitive dysfunction.
Once this complication occurs, especially for this irritable patient, there is only one way to stop it.
The so-called “sedation” is the use of strong sedatives to completely sedate him until he falls asleep. If you wake up and are still noisy, then continue to fight until you are fully awake. The main purpose of such a town is to prevent patients from being injured.
Look carefully at his arm, fortunately he has venous access. After a shot of a powerful sedative, the patient gradually lost consciousness.
In order to prevent him from being injured again when he wakes up, the nurses brought restraints from the intensive care unit.
The next day, it is said to be the same.
Day three, still the same.
On the fourth day, the person was finally fully awake.
However, when he wakes up, he has no memory of what happened before.
At this point, the postoperative cognitive dysfunction finally improved safely.
【Knowledge point】In the past, it was believed that the incidence of postoperative cognitive dysfunction in patients with general anesthesia was significantly higher than that in patients with spinal anesthesia, but the latest research shows that there is no significant correlation between anesthesia methods and POCD. Regardless of general anesthesia or local anesthesia, the postoperative cognitive function is less affected. Therefore, it is necessary to start from multiple directions. For example, accurate identification of high-risk groups of postoperative cognitive dysfunction before surgery; refined anesthesia and reduction of stress response during surgery; and early postoperative intervention.
[Warm reminder] Please pay attention, here are a lot of professional medical science, to reveal the secrets of surgical anesthesia for you~