Ms. Tian, 41, found something growing on her kidney during a recent physical examination. After consultation with the doctor, it was considered to be benign, but it was also recommended that she be surgically removed as soon as possible. So, she found a time to be hospitalized.
In the period before the operation, she had been inquiring about everything about the operation. Even what kind of anesthesia should be used, she studied it.
Seeing that anesthesia accidents seem to be mostly general anesthesia, she asked the doctor to give her half anesthesia. She believes that the consciousness is awake during the half anesthesia, so she can control some things.
In medicine, there is no such thing as half anesthesia. Half anesthesia is actually relative to general anesthesia. Epidural anesthesia, spinal anesthesia, and combined spinal-epidural anesthesia generally produce lower body anesthesia effects. Therefore, it is considered to be half-hemp.
Although general anesthesia is currently used for the vast majority of surgeries, semi-anesthesia is theoretically an option for this operation. Therefore, the anesthesiology department did not reject her request.
On the day of the surgery, Ms. Tian was very nervous. Especially during the anesthesia process, before the needle touched the skin, she would reflexively hide.
She hides like this, which obviously has a serious impact on the safety of anesthesia. In the event of tampering during the puncture process, the puncture needle is likely to accidentally injure the nerve.
Under the anesthesia doctor’s instructions, she finally refrained from moving and cooperated with the anesthesia.
5 minutes after infusion of experimental local anesthetic, there was no sign of general spinal anesthesia. So the anesthesiologist injected the full amount of anesthesia. After the evaluation surface T5 to L3, the patient was placed in the right lateral decubitus position.
Kidney surgery requires the use of a lumbar bridge device. This device is placed on the contralateral waist, so that the position of the operating side waist can be better exposed, so as to facilitate the operation.
However, when the top of the waist bridge was at her waist, Ms. Tian suddenly found it difficult to breathe. However, after several rounds of harassment by medical staff, she did not dare to express her opinion. She was thinking, maybe this is what the surgery requires. Surgery, how can it be so comfortable, bear with it.
Twenty minutes after the operation, she explained to the anesthesiologist that she was having trouble breathing. After the anesthesiologist checked for a lap, important indicators such as blood pressure, blood oxygen, and heart rate were all OK. Thinking she might be too nervous, a sedative was given to her.
However, after only 5 minutes, Ms. Tian’s head tilted and she could no longer wake up. At this time, looking at her, her lips were already purple. In the lateral recumbent position, the breathing state is not easy to observe, and only the blood oxygen can be seen dropping at a speed visible to the naked eye. At the same time, the heart rate is elevated, and the anesthesiologist judges that severe respiratory depression may have occurred. Therefore, the doctor on the stage quickly asked the doctor to protect the surgical incision, and everyone quickly flattened her.
Oxygen, boosters, and rapid fluids are administered immediately after laying flat.
After confirming that the patient’s heart has not stopped and the ventilation is in good condition, everyone’s tense mental arithmetic is relieved. They know that this situation is not difficult for anesthesiologists.
In just a minute or two, Ms. Tian’s lips returned to rosy. On the monitor, blood oxygen also returned to 99%.
After more than ten minutes of tossing, the sedatives are almost metabolized, and Ms. Tian’s spontaneous breathing can already meet the breathing requirements. Therefore, everyone fixed Ms. Tian on her side again and continued the operation. The difference is that this time the waist bridge is not made that high.
Although the field of vision is not as clear as it used to be, the surgeon at the moment dares not ask for anything. After all, something almost happened just now. Moreover, in the emergency event analysis, the anesthesiology department also pointed the finger at the high waist bridge.
It is precisely because the lumbar bridge is too high that some respiratory depression due to spinal anesthesia is aggravated. However, the anesthesiology department did not completely transfer the responsibility to the surgery department, arguing that sedatives should not be used when the patient is irritable. At the time, I thought the patient was just too nervous. Because this patient was very nervous from the time of surgery or even before surgery, habitual thinking thought that she was caused by nervousness.
After this event, the surgical, anesthesiology and nursing teams had an in-depth discussion. main purpose,Just to avoid similar situations in the future.
Here, I would also like to say a word to friends who have undergone surgery: It is inevitable to be nervous during surgery, but you must also learn to control it. Has been very nervous, easy to mislead the doctor’s judgment. In addition, if you really feel uncomfortable, you must not be polite or dare to say it. When things do happen, the medical staff won’t blame you.
[Warm reminder] Please pay attention, here are a lot of professional medical science, to reveal the secrets of surgical anesthesia for you~