A few days ago, an anorectal department once again let everyone appreciate the wide range of knowledge involved in anesthesia.
Here's the thing: In an unusual proctology operation, Dr. Lee, who was in charge of anesthesia, found some abnormalities. What surprised him most was that this person did not enter the operating room, but pushed into the operating room with a flat cart. Under normal circumstances, such minor surgeries do not require a car to transport.
Asked the nurse in charge of picking up the patient, the nurse said: The patient's legs are weak and he can't walk.
Hearing the words "can't walk", Dr. Li immediately became alert. This is because if there is a problem with the movement or sensation of the lower limbs, it is generally necessary to avoid spinal anesthesia as much as possible. Once there is a controversy after surgery, it is difficult to explain. Therefore, everyone will try not to walk by the river.
After the patient lay on the operating table, Dr. Li connected various monitoring devices to the patient and investigated the patient's lower limbs. His main attempt was to figure out why the patient was bored.
Hearing Dr. Li ask him about his legs, the patient said with a look of pain: The legs are fine, once you have hemorrhoids, you will not have energy, and your legs will be sore.
In the occupation column of the medical record, it is clearly written "driver", and he works in the bus company. Such a professional background can basically completely rule out his legs and feet. In other words, what he said should be true: as soon as he is sick, his legs are weak.
So the question is: where is the connection?
Hemorrhoids - legs, hemorrhoids - legs, Dr. Lee is racing in his brain looking for answers.
Suddenly, he blurted out: I see.
The anorectal doctor who was waiting for Dr. Li to change the anesthesia program asked: Do I have to change to general anesthesia?
According to his experience: in this way, the lower limbs may be problematic, and the anesthesiology department will almost always directly change the anesthesia.
Although they have ideas about such an approach, they can understand it. After all, medical work itself is tiring, and no one wants to get involved in things other than medical care, such as disputes. Directly change to general hemp, well water does not violate the river water, there is no suspicion at all.
Soon, Dr. Li turned the patient over and posed him in a lying position on his side.
Seeing that Dr. Li was going to fight with anesthesia, the anorectal doctor asked suspiciously: Is this leg all right? The implication is that you are not afraid of getting into trouble?
Dr. Lee knew what he meant, and said in a stroke of the aisle: say it later, first under anesthesia.
Soon, the anesthesia was well understood.
When the anorectal surgeon finished the critical stage of the operation, he brought up this topic again: Teacher Li told us about it, what is the connection between this?
Dr. Li took out his mobile phone and showed them a picture.
At first glance, it is a human anatomical map, which mainly shows the distribution of the ganglion segments of the lower limbs.
Just when everyone was still scratching their heads, he pointed to the "S2" in it. It can be clearly seen that "S2" not only dominates the back of the thighs and heels, but also distributes to the perineum.
Dr. Li went on to explain: From this picture, it is very good to explain the reason for his "weak legs". In the case of simple internal hemorrhoids, its nerve distribution is not associated with S2.
The anal canal is mainly innervated by the subhomorrhoidal nerves of the branches of the pudendal nerve, the anterior sphincter nerve, the caudal anal nerve, and the perineum branch of the first sacral nerve.
However, if it is an external hemorrhoid or fissure, it will directly touch the range of S2. And because S2 is also responsible for the sensations in the legs, the signals that are transmitted to the brain may be mistaken for the legs hurting.
Especially when the pain is particularly intense, it may feel sore and weak.
Speaking of this, everyone suddenly realized, and praised the anesthesiologist's anatomical skills.
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