Late at night, an emergency splenomegaly rupture operation was intense.
The patient is a middle-aged male in his 50s. The huge impact not only caused him to have a rupture of his spleen, but also a concussion. After being sent to the hospital, there was no communication at all. In view of the urgency of the condition, after consulting the hospital leaders, the operation began quickly.
During the operation, the surgeon clears a large number of blood clots from the abdominal cavity. The anesthesiology department made every effort to expand the volume of blood transfusion and rehydration fluids, plus the infusion of vasoactive drugs, and there was no danger of withstanding shock and cardiac arrest that could occur at any time.
When the spleen is successfully removed, everyone's heart can finally be released. The atmosphere on the stage immediately became relaxed: the surgeon was there to brag about how he had found a ruptured spleen at a glance, and the nurse was there to hold it and say...
The anesthesiology department across the curtain also wants to relax, but the "battlefield" after the rescue just needs to be cleaned up, so it is not easy.
After a large number of blood transfusions and rehydration fluids, the patient's face is obviously somewhat edematous. Pulling open the eyelids, the watery bulbous conjunctiva says it all.
After making sure that there are no major problems with the heart and lungs, the anesthesiologist begins to adjust the vital indicators. The goal is to adjust the patient's life indicators to a satisfactory state before the end of the operation.
If the patient can wake up during the procedure, it is perfect. Patients in their 50s, who are still in good health, do not enter the intensive care unit for such trauma. Once in the intensive care unit, it almost changes the family's quality of life later.
When preparing to sew the knife edge, the surgeon asked: How? Do you need to go to the ICU?
The ICU is the intensive care unit. In general, it is prepared for patients with unstable vital signs.
Hearing such a question, the anesthesiologist confidently said: No!
Although the patient has not yet woken up, he still has this confidence after years of experience in the big scene.
In fact, after nearly half an hour of "emergency march" to adjust the various life indicators, anesthesiologists almost dared to clap the patient to wake up and extubate smoothly.
At this time, he suddenly remembered one thing: what to do about analgesia after surgery?
The safe exit of the patient from the operating room can only be said to be a victory. But if the patient grins in pain, won't the victory be greatly reduced? Moreover, they are all shouting for comfort medical treatment. The patient came out of the operating room in pain, which is not the case.
So, with a "snap" he broke open a local anesthetic and handed it to the nurse on the patrol and asked her to get it on the operating table.
Seeing that the local anesthetic was on the stage, the nurse on the stage was stunned at first, but quickly reacted: I don't know how long ago, I used local anesthetic, it was used for pain relief.
Seeing that the nurse handed over the local anesthetic, the surgeon asked: Isn't there an analgesic pump?
The anesthesiologist said: There is no family member before the preoperative signature, the patient himself is unconscious, and the analgesic pump cannot be explained at all, so make an incision for him to infiltrate the analgesia. With this, you can also top five or six hours.
After that, the operation was successfully completed and the patient woke up and successfully extubated.
I thought that this was another anesthesia to satisfy myself, a good memory.
However, what happened after that made the anesthesiologist a bit blocked: when he was discharged from the hospital, the family questioned whether the local anesthetic on the stage was overcharged.
The reason for the family is that everyone uses analgesic pumps, so why not give them? In addition, since you have a unique path, why does it still hurt?
In the face of doubts, the anesthesiologist is naturally very angry: this is not thankless!
Although I am not happy in my heart, I also have to adjust my mentality to do the work of explanation.
In response to the family's question of "why not use analgesic pumps", he explained: Analgesic pumps are self-funded items, and medical insurance does not reimburse them, so they must communicate and sign before surgery. However, before the operation, the patient was not awake, there was no family around, and the situation was urgent, so he could only consider the problem of saving his life first.
In response to the problem that the family said that the effect was not good, he explained: Doing incision to infiltrate the analgesia can only reduce the pain. Even with an analgesic pump, it is difficult to guarantee that it will not hurt at all. Although it is theoretically possible, it requires an anesthesiologist to serve only one patient during and after surgery. Obviously, no hospital can do it at the moment.
Seeing that the family no longer said anything, the anesthesiologist said helplessly: You know what? The installation of analgesic pumps also requires a postoperative analgesic fee. However, there is currently no charge for incision infiltration analgesia, so only one medicine is charged. Perhaps, it is because there is no such fee that you feel inexplicable.
Hearing this, the family members left with an embarrassed face.
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