A common anesthesia 1, general anesthesia general anesthesia that is general anesthesia, usually by tracheal inhalation and intravenous injection of anesthesia drugs to complete, in order to facilitate intraoperative respiratory management and monitoring of vital signs, the need for endotracheal intubation and real-time monitoring of arterial blood pressure, the intubation of anesthesia has been induced, so the patient is unaware of the patient himself. The person is awake during arterial cannulation and establishment of venous access, so a certain amount of pain will be felt, more pronounced with arterial puncture, so local anesthesia of the skin will be performed, however, there is a certain failure rate of cannulation, and pressure is required for a longer period of time after the failure in order to avoid hematoma. Sometimes, a cuffed sphygmomanometer in the upper arm is also used instead of arterial monitoring. Common spinal surgery includes: anterior (posterior) cervical spine surgery, lumbar decompression and fusion internal fixation and open thoracic spine surgery. 2.Local anesthesia Local anesthesia is local anesthesia, i.e., anesthesia is given around the surgical area during surgery to reduce the pain, and the patient is awake during the surgery and can cooperate with the operator to complete the surgical process. Common spinal surgeries include: percutaneous kyphoplasty (PKP), intervertebral foramenoscopy nucleus pulposus removal and so on. Epidural anesthesia and lumbar anesthesia were commonly used in lumbar decompression surgery in the past, but with the change of surgical methods in recent years, this kind of anesthesia is used less and less. Preoperative anesthesia-related preparations 1, fasting and water Preparation for surgery should be a light diet, the day before the operation to start fasting preparations. General anesthesia, the patient is in a “dream” state, there is no response to the outside world, their own reflexes, such as choking and coughing and other protective reflexes will be inhibited, if vomiting, easy to accidentally inhaled into the lungs or trachea, resulting in pneumonia or asphyxiation. Generally, it is required to abstain from food and water after 12 o’clock in the evening of the day before the operation. However, strictly speaking, the time required for fasting is: (solid food), (milk, drinks, etc.), (water). Do not worry, although you can not eat water, the doctor will be based on human consumption of intravenous fluid supplementation. 2, drugs Antihypertensive drugs: the morning of the operation, antihypertensive drugs should be taken routinely, and can not be stopped arbitrarily. At this time, only a small mouthful of water to send drugs or sublingual can be taken. However, “Prilosec” and “Sartans” may interact with the anesthesia drugs during the operation and it is recommended to stop taking them on the same day and replace them with other drugs. Risperdal: When taking risperdal, the catecholamines in the patient’s body are depleted, and the pressure-raising effect of ephedrine and dopamine becomes poorer or even disappears, which makes it easy for serious hypotension and heart rate slowing to occur after anesthesia. Therefore, patients undergoing elective surgery should stop taking drugs for 1-2 weeks before anesthesia. After stopping the drug before surgery, it is necessary to switch to other antihypertensive drugs under the guidance of physicians. Common antihypertensive medications that contain the ingredient rifampicin include: Beijing Biaojiao 0 and Compound Biaojiao Tablet. Aspirin, warfarin, clopidogrel (Polivir, Taiga) or blood-activating Chinese (adult) medicines: anticoagulant and blood-activating medicines, when applied for a long period of time, will increase the amount of bleeding in spinal surgery, especially increase the chance of hematoma after cervical and thoracic spine surgery. Therefore, clopidogrel should be discontinued for 1-2 weeks and aspirin for more than 3 days before surgery. Switch to low molecular heparin subcutaneously if necessary. Blood-activating Chinese (adult) medicines should also be discontinued as early as possible. Glucose-lowering drugs should be discontinued in diabetic patients after preoperative preparatory fasting. It is recommended that glimepiride and glinide be discontinued for 24 hours preoperatively, and metformin should be discontinued 1-2 days preoperatively in patients with renal insufficiency, and insulin should be switched to if necessary. Anti-tuberculosis drugs should be used consistently, even on the day of surgery should not be discontinued, especially when the tuberculosis is active and the blood sedimentation is fast, arbitrary discontinuation of the drug is likely to lead to tuberculosis dissemination and elevation of blood sedimentation. People with abnormal thyroid function should monitor the indicators of thyroid function and adjust the dosage of drugs in time, especially eugenol, etc., which can be stopped on the day of surgery and taken in time on the second day after surgery. 3.Quit smoking and alcohol cessation Long-term smoking will increase the incidence of bronchitis, emphysema, pneumonia or lung cancer, but also increase the secretion of sputum after the operation, and complicate pneumonia or pulmonary atelectasis, in addition to this, smoking is also prone to increase the chances of strokes, heart attacks and so on. Long-term heavy drinking can affect the metabolic rate of liver drugs and increase the risk of anesthesia. 4, health preparation The night before the operation should be clean skin, bathe and change clothes, surgery needs should also be in the medical guidance to prepare the skin of the operation area, such as neck surgery need to be shaved, the back of the neck surgery should be haircut, close to the perineum surgery should be shaved. A large number of studies have confirmed that the use of chlorhexidine bath the day before surgery can reduce the infection rate of the surgical site. 5, dress ready to dress in surgery should be simple, simple, outerwear should be hospital uniform uniform surgical clothing, such as the torso area of the surgery, should be prohibited to wear corset underwear, do not be afraid to wear less cold, the temperature of the operating room will be higher than the general ward temperature, simple clothing to keep warm is not a problem. 6, avoid tension Pre-operative anxiety and tension is inevitable, but excessive tension is prone to cause elevated blood pressure, increasing the risk of anesthesia. In fact, after general anesthesia, people are like sleeping, and so wake up surgery will be over, so, since the choice of surgery, we should trust the surgeon and anesthesiologist, try to relax is. 7, avoid heavy makeup, jewelry Do not wear heavy makeup during surgery, do not wear gold and silver, try to remove all jewelry, hair clips, dentures, contact lenses, etc., to avoid the use of scalpels during the operation when the metal burns the skin. If you really can’t remove the jewelry, such as jade bracelets, rings, etc., you should inform the ward, operating room nurses, doctors, respectively, for safety package treatment, and bear the loss by yourself if it is damaged. 8, attention during menstruation In principle, elective surgery should not be performed during menstruation, however, if required by the condition, the 2nd and 3rd days of menstrual blood should be avoided, and at the same time, menstrual hygiene should be strengthened. Third, the day after the operation notes 1, position After general anesthesia does not need to go to the pillow, just lie down on the line. We say that after anesthesia to go pillow lying down for at least 6 hours, refers to the epidural or lumbar anesthesia and other intravertebral anesthesia, mainly to prevent low cranial pressure headache. Spinal surgery after lying in bed can be free to turn over, the body does not have to be like an iron plate. 2, diet General anesthesia 6 hours after the operation need to prohibit food and water, so as not to cause vomiting, accidental aspiration. You can use cotton swabs dipped in water to prevent dry lips. 3, pain after spinal surgery will be different degrees of pain, if the pain is more sensitive, you can choose the analgesic pump, by pressing the button on the pump to release the analgesic to relieve pain, such as the effect is not good, or cause serious dizziness, vomiting, should be turned off the analgesic pump, ask the doctor to use other pain medication. 4, vomiting Vomiting after general anesthesia or lumbar anesthesia often occurs, middle-aged women more than men, often related to the residual reaction to anesthesia drugs, the use of analgesic pumps or weak physical quality. The head should be tilted to one side to prevent vomiting and cause aspiration. The day after surgery, you should mainly lie down, if there is no obvious discomfort, you can actively or passively move your limbs, after 6 hours, if there is no discomfort, you can also turn over and lie on your side. After 6 hours, if there is no discomfort, you can also turn over and lie on your side. 6. Diet Generally, you should not eat on the day of operation, but you can drink a small amount of water after 6 hours, and you should have a light and nutritious diet for a few days after the operation, such as meat broth, fish broth, noodle soup, vegetable porridge, and milk. You can choose appropriate fruits and so on according to whether you have diabetes, high blood pressure and so on.