Monday is destined to be a depressed day for Xiao Li in the anesthesiology department. I thought it would be a relaxing day, but the director asked her to temporarily take over the surgery of a sick colleague.
When she received this operation, she felt a lot of pressure in her heart. This patient does not look like a worry-free lord: a bearded man, a big red face, and a drunkard in that look. When I asked about my medical history, I was indeed drunk. It is said that you get a pound every day. Not only that, but I also have the habit of taking painkillers. Coupled with age, each one greatly increases the difficulty of anesthesia.
At this time, some friends may ask: Hemp is over, and no matter how large the amount of alcohol, it can also be numbed!
That being said, there is no one who can't get over it. However, how to ensure a smooth and safe awakening during the operation is the core of anesthesia.
To make matters worse, an inhaled anesthetic with a low rate of agitation during the waking period of the day happened to be gone. And she is accustomed to inhaling compound general anesthesia, and she can only harden her scalp.
At this time, there will be insiders who will say: Isn't it the end of direct upper venous general anesthesia? A large number of data show that there is significantly less restlessness during the awakening period of intravenous general anesthesia than inhaled general anesthesia.
She is very clear about this. However, there is a consensus in the anesthesia industry: choose the anesthesia you are better at, rather than choose the theoretically better anesthesia.
Considering that the male urinary catheter is the main cause of agitation during awakening, she specifically instructed the nurse who inserted the urinary catheter to apply some glue with anesthetic effect. But it turns out that the effect is not great. There may be a role, but the effect is not obvious in this patient.
During the awakening period, the real test came. Watching the BIS value rise little by little, she became more and more excited. Theoretically, as long as the patient is awake enough, it is generally possible to control restlessness.
In a hurry, however, she overlooked one thing: the seemingly quick-to-wake data masked the movement of the anesthetic gas being slowly released from deep tissues. Moreover, this process generally takes nearly half an hour.
In other words, the recovery of deep tissue from anesthesia is the real awakening, which is not at this time.
The patient was seen swallowing the endotracheal catheter, and a wake-up needle was injected into it. The stimulation of the tracheal catheter and the catheter instantly made the patient stop listening to the command and violently struggled to get up. That kind of power, several girls can't hold back.
Realizing that the patient had experienced awakening restlessness, Xiao Li decisively injected short-acting intravenous general anesthesia. In this way, the patient was numbed again.
This time, the patient slept for more than twenty minutes.
When I woke up again, I seemed to be a little more sober than before, but I was still almost drunk.
In this way, you can only administer the drug again and continue to sleep.
After another ten minutes, the patient was finally fully awake. However, the stimulation of the catheter still made it difficult for him to calm down.
At this time, Xiao Li recalled: This person has prostatic hyperplasia. In such patients, urethral irritation is stronger.
After much thought, I decided to inject him with a long-acting painkiller to relieve the stimulation of the catheter.
After the patient calmed down again, everyone sent the patient out of the operating room.
At this time, Xiao Li has mixed feelings in his heart: success in this work is a matter of duty; if you are not successful, others may think that your level is not good. As everyone knows, one patient after another has exactly the same physique and the same surgery. And these are all factors that affect the quality of anesthesia.
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