The anesthesia in the eyes of the surgeon is what it looks like

“The bright moon is born in the sea, and the world is at the same time.” I sent away the last patient, dragging my tired body and trying to fall asleep when the phone in the duty room suddenly rang, and in the dimness, the conditioned reflex jumped up and grabbed the phone:

“Anesthesiologist, I just received a shoulder dislocation, the patient is tense, and the muscles are too developed, it is not easy to reset, can you go to the emergency room and give me a little muscle relaxation, let the muscles relax, Okay?”

Listening to the anxious words of the orthopaedic doctor, I lost sleep, and my brain began to speed up: muscle relaxants are referred to as muscle relaxants. These drugs selectively act on neuromuscular junctions, temporarily interfering with normal muscles, neuromuscular excitation is transmitted, thereby causing muscle relaxation. The muscle relaxants in our clinical anesthesia are mainly used for the induction of anesthesia to facilitate tracheal intubation and maintenance of anesthesia. According to the needs of anesthesia and surgery, it maintains a good state of muscle relaxation and facilitates surgical operations.

Muscle relaxants not only relax skeletal muscles, but also relax respiratory muscles. The use of muscle relaxants must assist breathing or control breathing, to avoid the serious consequences of muscle relaxants resulting from respiratory muscle relaxation.

“Oh, yes, let’s see if you can give us some milk, (propofol), let the patient sleep, we’ll be fine soon, just a few minutes That’s enough.”

Has the patient fasted enough? “

The patient had just finished dinner and drank some wine. On the way home, his feet slipped and his hands rested on the ground, resulting in a dislocated shoulder. “

“That may not work. Before giving milk propofol, the patient must fast. During anesthesia, the patient’s throat reflex is weakened or disappeared, and the patient is prone to reflux and aspiration. The risk is extremely high. Once the patient experiences reflux aspiration, it will bring serious consequences to the patient, which may be life-threatening.”

“This patient is really difficult to reset. I have just tried several times, but it has not recovered. Let’s see if you can think of a way for us?”

“Which clinic are you in now? I need to see the patient before I decide.” Putting on my work clothes, I made up for the anxious mood of the doctor and the pained face of the patient. I came quickly. to the clinic. This is a young and middle-aged man, and the orthopedic doctor next to him is a little thin because of his tendons… Now the patient is frowning tightly, his facial features are crowded together, and the orthopedic doctor next to him is sweating profusely. It seems that he has suffered a lot!

I carefully inquired about the medical history and checked the examination report. The patient’s anesthesia needs to complete some necessary examinations. Please accompany the nurse to complete the examination… After the examination, I will start to make an anesthesia plan according to the patient’s condition. Fortunately, the patient’s indicators were normal, and he explained the required anesthesia method, related complications and risks to the patient in detail, and the patient also accepted it. Under the condition that most of the conditions meet the requirements of anesthesia, “ultrasound-guided brachial plexus block” anesthesia is finally selected.

The anesthesia process was smooth, and under the blessing of anesthesia, the orthopedic surgeon’s manual reduction was also successful. In the patient’s grateful eyes, when he was sent out of the operating room, Dongfang was already slightly pale, and it was another sleepless night. Since he didn’t sleep, he habitually reviewed the process of night shift work, if there was any problem, he could learn from it.

From this incident, as an anesthesiologist, I deeply feel that the anesthesiology department has always been mysterious to the outside world, and it is also a department that is easily misunderstood. The impression of the outside world has always been that the “anesthesiologist” just pushes a drug, and then you can do whatever you want. The work is simple and easy. This is probably a common view of the outside world on our anesthesiologists.

In fact, anesthesia is a very complex subject. During the entire perioperative period, anesthesiologists play a vital role, especially during the operation, to protect the patient’s life during the entire operation. Physical signs are stable, and at the same time, the safety of the patient’s life must be guaranteed.

In order to deepen the public’s understanding of anesthesia, my country has designated the last week of March as “China Anesthesia Week” since 2017. This year’s theme is “Respect for Life, Pay Attention to Anesthesia— —Without me, the operation was once unbearable; with me, safety and painless can be guaranteed;

Author: Zhejiang Xin’an International Hospital, Tang Huadong (Jiaxin Tang)

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