Beijing Anzhen Hospital, Anesthesia Center, Wang Jianyu
When I first started, I felt that general anesthesia surgery was nothing more than a combination of three types of drugs and five or six drug names. Doing an operation is more like a One Night stand. Do your best, leave no regrets, and satisfy yourself. Apart from these, there seems to be nothing special that you need to pay attention to.
To this day, when I look back on my mental journey that I have worked for ten years, I feel even more that, in fact, for every operation, we are more like a relationship with a patient, and we are similar to love. The male side of the patients, while the patients played more roles similar to the female side. Of course, if everything goes well, we will feel very happy and full of a sense of accomplishment; if there are setbacks, we may need to find them early and make adjustments and corrections by ourselves in order to return to a smooth route in time; Sad reminder, that is, failed to find the crux of each other’s problems, resulting in irreversible mistakes in the process, and finally ended in failure.
A surgery is the same as a real romantic experience. It needs an introducer or a medium, and this person is often the chief inpatient in the anesthesiology department. The hospital always assigns the patient to the doctor who is going to perform anesthesia for the patient the next day, which is equivalent to the introduction of the two men and women. Let the anesthesiologist know the patient’s past medical history, surgical history, drug allergy history, as well as the appeal and purpose of the operation, just like knowing the woman’s past emotional experience and the basic goal of this mate selection. Of course, before this, it is first necessary to evaluate whether the anesthesiologist’s professional ability is competent for this operation, which is equivalent to understanding the basic information and personal strength of the man.
The rest is for the anesthesiologist to understand the current basic condition of the patient through inpatient medical records, auxiliary examinations, and laboratory tests, which is similar to the man’s tentative inquiry into the woman’s family background, personal preferences, learning experience, etc. Wait. With a preliminary understanding of everything in place, most anesthesiologists will choose to go directly to the ward to conduct a preoperative visit to specifically understand and verify the general physical condition of the patient, and visually assess the patient’s current condition, which will help formulate a specific anesthesia plan. Similar to the first meeting of a man and a woman, you usually meet in a relatively quiet place such as a coffee shop or a western restaurant, sit down and have a preliminary chat to see if the information you have learned before is true, and whether you need to deepen your understanding of some new information. . Often after this meeting, the beginning of love will be accepted psychologically, and the next love plan will be started.
A truly definitive relationship often occurs after a series of specific understandings. The anesthesiologist and the patient will have a renewed rational to emotional understanding of the patient through the communication and education before the operation and the monitoring of vital signs in the operating room. preparation stage. According to our country’s existing national conditions and established customs, when a man and a woman fall in love, from the beginning stage, the man usually sends a small gift to the woman on his own initiative. The small gift that the anesthesiologist gives the patient is often a 16G or 18G trocar, which is conducive to rapid intraoperative fluid rehydration; there is also invasive blood pressure monitoring after local anesthesia, in order to better observe the patient’s vital signs changes in real time; Some will choose to give the patient a central venous catheter according to the specific condition, so that the drug can be administered quickly.
With the deepening of the relationship and the strengthening of the emotional integration between the two parties, some minor conflicts and even minor frictions cannot be avoided by both men and women. The woman sometimes has a little temper and a little temper. Usually, the more sensitive man will take the initiative to correct this kind of emotional conflict, so that the emotions of both parties will be on the right track in time. A man with a big heart often ignores the small changes in the details at the beginning. If the woman knows how to restrain herself, she may be able to return to normal. If the woman goes farther and farther in the state of ignoring emotions of the man, there will definitely be a big contradiction. Conflict, if the man still does not find out or is too tired to manage, in Beijing dialect, it is a state of “comparative work”, the woman will really drift away from the state you want, and the outcome can be imagined.
This process description is very similar to anesthesia induction, which is the process by which the anesthesiologist uses drugs to bring the patient from the natural physiological state into the general anesthesia state. No matter how skilled anesthesiologists are, it is difficult to guarantee that every one of their patients will be able to keep their vital signs, hemodynamics, internal environment and other data stable during the induction period. In other words, a little fluctuation is normal. or unavoidable. Then, experienced anesthesiologists often prepare in advance, intervene through drugs and other methods, and try to maintain the stability of the patient’s vital signs and internal environment as much as possible, and there is no large-scale fluctuation in hemodynamics. This is in love, similar to the woman’s pettiness, the man must know the truth of coaxing in time.
If the anesthesiologist ignores the fluctuating state or attempts to allow the patient to correct fluctuating vital signs on their own, young, generally healthy patients may have fewerSome people can really adjust their physical state to a relatively stable state through self-regulation. This state is similar to that of a man and a woman in love. When there is a conflict, the woman is knowledgeable and tolerant, and her feelings recover. It is completely the woman. The generosity and the good luck of the fool.
In half an hour after the end of the induction period, the anesthesiologist is usually the time when the anesthesiologist fully understands the patient’s process, and is often the time when the anesthesiologist has the highest sense of presence and the busiest time during an operation. At this stage, we need to fully understand the general condition of the patient after anesthesia, the internal environment of the body, the condition of cardiac function, the degree of fluid demand, and the sensitivity and adaptability to different vasoactive drugs. Similar to the period of love, the man must understand where the woman’s bottom line is. The purpose of understanding is to stay away from the bottom line, not touch the bottom line. If the man really “makes” and frequently touches the bottom line of the woman, the woman will definitely interpret the classic Internet phrase for you – no zuo no die.
Do not touch the bottom line of both parties, let everyone communicate comfortably, and carefully maintain each other’s emotions. Most men and women in love will definitely have lovers who will eventually become married. This is like an anesthesiologist working hard to monitor his patients, cooperating with the surgeon to complete the operation, allowing the patient to go through the recovery period and the perioperative period smoothly, and finally achieve a satisfactory result.
Suddenly wanted to write something I wanted to say for a long time: Anesthesia that does not aim at surgical safety and patient comfort is a hooligan.
I would like to write this article to commemorate my inner feeling of working in the Anesthesia Center of Beijing Anzhen Hospital for ten years, and to express my feelings that have guided me, helped me, and encouraged me in the past ten years. Thank you teachers and friends!
May 21, 2022 Written at home
[Warm reminder] Please pay attention, here are a lot of professional medical science, to reveal the secrets of surgical anesthesia for you~