On Monday, the orthopaedic operating room was the first to complete anesthesia. While the doctors in the other operating rooms were still brushing their hands, the skin had already been cut here.
Listening to the hemostasis of the electrosurgical knife, Dr. Zhao, who was in charge of anesthesia, wrote all kinds of documents and anesthesia records.
The rising blood level in the attractor made him a little more worried. He was thinking: an ulnar mass, as for so much blood? So, while he was busy recording, he paid attention to everything on the stage and the changes in his vital signs.
Because the patient was nervous listening to the doctor’s operation, Dr. Zhao put him to sleep with a sedative.
Amid the snoring, everyone went about their own business.
Suddenly, Dr. Zhao found that the pressure value of the blood pressure monitor was a little low this time. With the gradually rising heart rate, his heart added a tension.
Anesthesiologists who deal with life every day, even if the blood pressure has not been measured, can judge the approximate level of blood pressure from the degree of inflation of the blood pressure cuff.
After the blood pressure value came out, Dr. Zhao’s first reaction was to doubt whether there was a large amount of blood loss in a short period of time.
In the operating room, blood loss is the most common cause of a sudden drop in blood pressure.
However, only five or six hundred attracts within the attraction seem to remind him that “it’s not me.”
Have a cardiac event?
Only a few fast, regular ECGs that seem to say “not me” too.
The three main factors that maintain blood pressure are blood volume, cardiac dynamics, and peripheral resistance.
Since there is no problem with blood volume and heart, there is a high probability that there is a problem with peripheral resistance.
So, what is the reason?
In seconds, one question after another passed through Dr. Zhao’s mind. At the same time, one after another was denied.
The most common cause is deep anesthesia. However, this surgical anesthesia is a nerve block. In theory, there is no deep question. Only general anesthesia can be defined by depth.
Wrong blood pressure medication?
Impossible. This nerve block works very well, and the patient’s blood pressure is not particularly high. Therefore, the use of antihypertensive drugs or overdose can be completely ruled out.
While thinking about it, Dr. Zhao’s eyes fell on the dexamethasone he was pumping.
Is it it?
No. In theory, the process of taking this drug can indeed lead to a drop in blood pressure. However, there is no possibility of a cliff-like descent!
What’s the reason for that?
Looking at the “sleeping” patient, he was momentarily lost. However, this time, you can’t be confused forever. The safety of the patient’s life depends entirely on his judgment and treatment.
In an operation, the anesthesiologist is always on the timeline. This timeline is the changes in the patient’s vital signs as well as the various operations and treatments as the operation progresses and the anesthesia time goes on.
In seconds, he reviewed the patient’s timeline.
Suddenly, he thought of a problem: During the operation, he found that the nerve block he had taken before seemed to be ineffective. So he added another injection of local anesthetic at the nerve block site. The blood pressure drop this time happened just after the anesthesia.
Could it be local anesthetic poisoning? A judgment that made him tremble emerged in hismind.
After determining that there was no other cause, he became more and more convinced that it was local anesthetic poisoning. So, quickly expand and boost the patient’s volume. At the same time, changes in the patient’s vital signs are monitored.
During the period, he was fortunate several times that he was not using a long-acting local anesthetic, nor a local anesthetic with high myocardial toxicity. If so, the consequences would be disastrous!
After nearly half an hour of hard work, my blood pressure finally stabilized.
Looking at the patient who was still sleeping, he thought to himself: Maybe, you never knew such a thrilling scene happened during the operation.
How he reported this lesson to Corey the next day in hopes of avoiding a similar incident in the future.
During the period, some people also questioned a question: in local anesthetic poisoning, the patient’s consciousness should be excited first and then turned into inhibition.
He reminded everyone that this patient took a sedative and passed the excitement phase directly. At the same time, it is added: If the high-dose local anesthetic is rapidly injected into the blood, it may also directly cross this exciting stage.
In sedation or general anesthesia, significant inhibition of circulation may be the only symptom of local anesthetic poisoning.
Hearing this, everyone felt that they had learned a lot from this event.
In this case, did anesthesia refresh your cognition?
[Warm reminder] Please pay attention, here are a lot of professional medical science, to reveal the secrets of surgical anesthesia for you~