In March, although there are occasional cold springs, it can’t stop the vitality of spring. This season, Xiao Li has been looking forward to it for a long time. To be exact, it has been expected for nearly ten months. Because she is 36 years old this year.
Ten months ago, when she learned that she was pregnant, she was excited to tell her. During that time, she almost wanted to tell everyone about her pregnancy.
However, PIH in the third trimester seems destined to be a test. Complications such as headache, dizziness, nausea, vomiting, etc., appeared one after the other. Finally, I persisted to 39 weeks. Under the persuasion of the doctor, she was admitted to the hospital, waiting for delivery.
She was relieved when she thought about going to the operating table, but the doctor’s words instantly made her feel desperate. This is because the doctor told her: the risk of anesthesia is very high! Moreover, they are all fatal risks!
Some people say: Pregnancy-induced hypertension, even if there are complications, is not that dangerous, right?
This is not about pregnancy-induced hypertension. Xiao Li also has a rare disease – congenital hemangioma.
The so-called congenital hemangioma is a benign tumor formed by the proliferation and expansion of skin capillaries. Most of the violations of the head, neck, skin, but mucous membranes, liver, legs and muscles can also occur. In the process of growth, the tumor can cause some complications, such as bleeding or ulcer, arteriovenous fistula and thrombocytopenia in case of trauma or infection.
Xiao Li’s hemangioma did not appear to be otherwise, but the location of the hemangioma was not good. A huge hemangioma covered half of her face. The most special is that her hemangioma “spread” to the buccal mucosa and tongue. Not only is the tongue body large, but the corners of the mouth are also severely deformed.
Some people will say: Don’t you put anesthesia on your waist when you have a baby? Staring at other people’s faces, isn’t it a bit too much to worry about?
As an anesthesiologist I would say that anesthesia is not that simple. Assuming that the anesthesia is as simple as a single injection, it can be punctured completely. However, the core of anesthesia is safety and ensuring the safety of patients. How to ensure security, we must have security measures. The guarantee of anesthesia methods cannot be “one road to Huashan”. When an anesthesia method fails, there must be a backup anesthesia method to ensure the normal operation of the operation and the safety of the patient.
Therefore, even if anesthesia in the waist is the first choice, it is at least an option for general anesthesia. It can be dangerous if general anesthesia is not available.
Some people said: The anesthesia failed, let’s do it another day!
It’s not that simple. If only the anesthesia method fails, you can indeed try again another day. However, if an anesthesia accident occurs during the implementation of anesthesia, some operations under general anesthesia (such as tracheal intubation) are required for rescue?
The unstable blood pressure and the impact of pregnancy-induced hypertension on various small arteries made Xiao Li feel very bad. Some examination results also showed abnormal signs of renal function and fundus arteries. With pregnancy-induced hypertension, the child in the womb is also at risk of ischemia. It can be said that mother and child are in danger at any time.
The obstetric department is anxious, the mother is anxious, and the family is anxious… It can be said that the pressure is concentrated on the anesthesiology department.
The matter of having a child cannot be mopped. It can be said that no matter what. However, how to get on and how to get on safely must be carefully studied.
On that day, everyone in the anesthesiology department worked overtime to discuss cases. The key to the discussion is which type of anesthesia to choose and how to keep mother and child safe.
After discussion, everyone agreed that: although general anesthesia intubation is more difficult, the risk of pregnancy-induced hypertension in the parturient itself has a greater risk to mother and child. Therefore, it is safer to go straight to general anesthesia. Regarding how to intubate, everyone has made a detailed plan.
On the second day, in order to ensure safety, the anesthesiology department deliberately cooperated with three people to implement anesthesia: one person was responsible for drug administration; one person was responsible for intubation; the other People move.
Stable operation is also the key to the successful implementation of this anesthesia: the maternal airway anatomy is severely abnormal, which means that there is a high possibility of emergencies. In view of this, the oropharyngeal airway was first placed in the mother under the action of some anesthetics. After the oropharyngeal airway is placed, the maternal airway is very clear.
Seeing this, everyone finally breathed a sigh of relief. So, quickly brush your hands to the stage and disinfect the towels.
In order to further shorten the time from the start of general anesthesia to the birth of the child and reduce the amount of anesthetics flowing into the child’s body, the anesthesiologist specially instructed the obstetrician to apply local anesthetic on the belly of the mother.
After seeing the obstetrician slitting the mother’s belly, the anesthesiologist quickly injected the full amount of anesthesia.
At the same time, the obstetrician stepped up to pick up the child. The anesthesiologist just finished the tracheal intubation when the child’s “quack” sounded on the stage.
Assessed: the Apgar score of the newborn was 8 at 1 min and 10 at 5 min. This means that the child is safe!
The operation lasted half an hour, and the vital signs were stable during the operation. After the operation, the puerpera had clear consciousness, good swallowing movements, strong handshakes, and good breathing indicators. So, the anesthesiologist was relieved to pull out the endotracheal tube.
[Warm reminder] Please pay attention, here are a lot of professional medical science, to reveal the secrets of surgical anesthesia for you~