Anesthesia is more than just a shot. The anesthesia drugs used by anesthesiologists are toxic, and there are risks associated with any anesthesia method, which is the original reason why patients need to talk and sign before surgery.
A patient with an upper limb injury, his vital signs were stable when he entered the operating room, while the anesthesiologist was making preparations the patient had a sudden onset of epilepsy, teeth closed, foaming at the mouth, general convulsions and respiratory depression, fortunately at this time the anesthesiologist scrambled for time and made all preparations, and after timely administration of propofol, seconal, and oxygen by face mask pressure, the patient soon turned to safety.
Since everyone tolerates and reacts differently to anesthetics, accidents and complications are inevitable in the process of anesthesia like this patient. These accidents include: respiratory and cardiac arrest, respiratory and circulatory depression, vomiting, regurgitation and aspiration, and nerve damage.
This is why anesthesiologists have to escort the patient throughout the surgery and adjust the anesthesia dosage according to the needs during the surgery. The purpose is to keep the patient’s life under normal physiological control at all times.
Because anesthesia work is closed in the operating room for a long time, the society and the medical community itself lack proper understanding and awareness of it. They only know that anesthesia is risky and they should find better anesthesiologists during surgery, but they do not understand the various factors that affect the safety of anesthesia. Professor Yang Jianping, a doctoral supervisor of the Department of Anesthesiology of the First Affiliated Hospital of SOU, said that, in fact, the risk of anesthesia is critical between life and death, and the change between life and death can occur in a short period of time. Therefore, surgery has size, anesthesia has no size, any anesthetic drug used by anesthesiologists is toxic, and any anesthesia method has certain risks, which is the reason why patients need to have pre-anesthesia talk and sign before surgery. Professor Yang Jianping cautions patients that if they value their lives, they should consider anesthesia as important as surgery.
The past life of anesthesiology
It is well known that anesthesia is a very important procedure in the vast majority of modern surgical procedures. Without the aid of anesthetics, few people would be able to endure the immense pain caused by surgery. Therefore, before the invention of anesthesia, surgical operations often failed because the patient died before the operation was over because he could not endure the severe pain.
In ancient times, people began to accumulate experience in anesthesia, but mainly applied vegetative anesthetics, but also used mechanical compression of the nerve trunk, drinking, bloodletting, etc. to make the patient lose consciousness, and even hit the patient’s head with a stick to cause coma “anesthesia” method, however, all these methods can not make people satisfied.
In 1842, Dr. Crawford of Georgia used ether anesthesia for the first time to relieve the pain of patients in surgery; in 1844, Dr. Horacewels demonstrated the use of laughing gas anesthesia for dental surgery; in 1846, Dr. Wiliom Morton shocked the doctors of Massachusetts General Hospital by using ether anesthesia. In 1846, Dr. WiliomMorton shocked physicians at Massachusetts General Hospital by using ether anesthesia. Soon laughing gas, chloroform, ether, and other anesthetic drugs were widely used to relieve the pain of surgical patients and to make surgery more humane when treating disease.
Anesthesia and surgery are twins
Anesthesia and surgery are actually twins, and neither one can work without the other. According to Prof. Yang Jianping, during surgery, the anesthesiologist is the direct object to give life support to the patient, and he has to supervise the patient’s heartbeat, blood pressure, respiration, body temperature and the balance of the internal environment and other series of vital signs smoothly. For different ages of surgical subjects, 20 years old, 50 years old, 80 years old, as long as the same disease, there is no big difference when the doctor is operating; however, the anesthesiologist has a world of difference when considering the anesthesia program. Only minor surgery, no minor anesthesia. For example, for a 90-year-old patient with coronary heart disease and poor cardiac function, who undergoes appendectomy for acute appendicitis, the anesthesiologist has to take great risks and responsibilities during the operation. Before anesthesia, the anesthesiologist must choose the anesthesia method, anesthetic drugs and intraoperative monitoring according to the pathophysiological characteristics and pre-existing diseases of the elderly patient, correct the patient’s vital function status in time according to the changes in the condition during surgery, and consider how to make the patient recover smoothly after surgery.
Anesthesia is more than just a shot
”Only minor surgery, no minor anesthesia”, the high-risk nature of anesthesia medicine is self-evident. Although anesthesia is reversible, the misfortune caused by anesthesia is often irreversible. However, the importance of the work of anesthesiologists is not yet well understood.
”Many people think that the job of an anesthesiologist is in the operating room.” Professor Yang Jianping says this view is incorrect. He told reporters that anesthesia risks exist before, during and after surgery, only the manifestations of anesthesia risks are different. Therefore, the anesthesiologist should not leave the patient during the operation, and should know every step of the operation and the next step well; he should have a full understanding of the indications, contraindications and interactions of various anesthetic drugs.
In clinical practice, even if a very experienced physician is not adequately prepared before a particular anesthesia, it will be impossible to compete for time and give full play to his or her technical advantages when an emergency arises. Therefore, anesthesiologists should anticipate and prepare for all kinds of problems that may occur in various parts of the surgery, so that they can be calm and unhurried.
The main thing about anesthesia is control
Most people think of an anesthesiologist as a doctor who relieves pain through medication and renders the patient unconscious. Few people realize that the task of today’s anesthesiologists in the operating room is not only to ensure patient comfort, but also to monitor and diagnose changes in important vital functions caused by multiple factors (primary disease, anesthesia, surgery, etc.) during surgery and recovery from anesthesia, and to provide timely treatment to ensure the safety of patients in the perioperative period.
According to Prof. Yang Jianping, anesthesiologists must rely on a variety of complex and sophisticated instruments to monitor patients comprehensively during the entire surgical procedure, make accurate and timely diagnosis and treatment of intraoperative changes, in order to maintain the normal function of patients’ vital organs and correct the depth of anesthesia in a timely manner. In other words, the anesthesiologist has to ensure the safety of the patient during the operation and create good conditions for the operation at the same time. After the surgery, the patient will be sent to the recovery room or intensive care (ICU) ward, and then back to the ward when the patient has fully recovered from the anesthesia. All of this requires the anesthesiologist to be fully prepared before surgery and to be at the patient’s side at all times during surgery.
Health Class;
What are the main types of anesthesia for surgery nowadays?
The main types of anesthesia are local anesthesia, regional nerve block, and general anesthesia.
Local anesthesia is usually applied to do a small range of surgery, and can be done by the surgeon himself in general.
Regional nerve block, usually refers to the intradural anesthesia (epidural anesthesia, lumbar anesthesia), brachial plexus nerve block, which is often referred to as “semi-anesthesia”. This type of anesthesia is more complex, requiring a full-time anesthesiologist to operate and manage, and its scope of application is significantly larger than that of local anesthesia, which can be used for appendectomy, cesarean section, upper and lower limb surgery, etc. Regional nerve block is an anesthetic option between local anesthesia and general anesthesia.
General anesthesia is characterized by temporary loss of patient consciousness, and it is usually said that general anesthesia is applicable to all surgeries. Some surgeries, such as craniotomy and thoracotomy, can only be performed with general anesthesia, while some surgeries can be performed with both general anesthesia and regional nerve block.
How to choose the type of anesthesia?
Generally speaking, the choice of anesthesia for a patient’s surgical procedure is determined by the anesthesiologist according to the size of the procedure, the patient’s own physical condition and his or her own proficiency in anesthesia. Some surgeries, such as craniotomy, thoracotomy, and cervical spine surgery, can only be performed under general anesthesia. For some surgeries, such as leg fracture without special medical history, you can choose general anesthesia or semi-body anesthesia, and the anesthesiologist will analyze the advantages and disadvantages of both types of anesthesia and decide on anesthesia according to the specific situation.
Due to individual differences and co-morbidities, each person tolerates and responds to anesthesia differently, and accidents and complications may occur during anesthesia.
Each kind of anesthesia risk and complication is not absolute for the patient, as the patient and his family, understand the possible risks and complications, once they occur, have certain ideological preparation, for the anesthesiologist, know this anesthesia method and anesthesia drugs may occur these risks and complications, then in the process of anesthesia to try to prevent its occurrence, and before the anesthesia to do a good anesthesia risks and complications may occur We will try to prevent these risks and complications during anesthesia, and make contingency plans before anesthesia when they occur.
Why do anesthesiologists need to visit patients before and after surgery?
The preoperative visit of the anesthesiologist is solely for the safety of the patient. Such as whether there is heart disease, hypertension, bronchitis, asthma, glaucoma and other diseases; allergy history: whether there are allergies to drugs (especially anesthetics) and food and the severity of allergic reactions; previous surgery and anesthesia history: whether they have received surgery and anesthesia? Are there any adverse reactions? To obtain information about the medical history, physical examination, laboratory tests, special examinations and the patient’s mental status as well as the proposed surgery, assess the risks, make analysis and judgment in order to improve the preoperative preparation and develop a suitable anesthesia plan. At the same time, according to the patient’s specific situation, he/she will get consensus with the surgeon on the risks of anesthesia and surgery and how to cooperate with each other, make necessary preparations before anesthesia, sign the anesthesia consent form, and answer the questions raised by the patient, etc.
The post-operative follow-up system of anesthesiologists not only reflects a kind of humanistic care of anesthesiologists to patients, but also gives us feedback on a lot of information about the anesthesia process, such as whether the patient is awake during surgery, how effective the anesthesia is, how effective the post-operative analgesia is, and whether there are any post-anesthesia complications and comorbidities, so that we can find and deal with them in time.
Why should I abstain from drinking and eating before surgery?
After normal diet, the body secretes a large amount of gastric juice, pancreatic juice and bile to digest food, which increases the stomach contents. The anesthetic drugs weaken the body’s normal protective reflexes, and the factors of surgery may cause nausea and vomiting. Once vomiting occurs, a large amount of gastric contents reflux, such as accidental inhalation of the airway, can cause respiratory obstruction and cause asphyxiation or even death of the patient. At the same time, the acidity of gastric juice is high, which is very irritating to the respiratory tract, especially the lungs, and accidental inhalation can easily lead to aspiration pneumonia, which can lead to respiratory insufficiency after surgery and affect the patient’s postoperative recovery. Therefore, patients undergoing surgery will be informed not to eat or drink after 8:00 p.m. (10:00 p.m. in the case of children) that night, in order to fast for 8 hours for adults and 4-6 hours for children.
Does general anesthesia have an effect on intelligence?
Many people are worried that anesthesia will affect their intelligence, especially children, and are afraid that it will have an impact on their future studies.
In fact, there is no need to worry about this. During the period when the anesthesiologist has administered anesthetics, there may be confusion and blurred consciousness. But there is a great characteristic of anesthesia drugs – reversibility. The so-called reversible, is the anesthetic effect of organs, such as the brain, after the anesthetic metabolism, will be fully restored to its original function, what to do what to do, unless the drug accumulation – but so far have not found a drug can affect people for years or even a lifetime.
The general anesthetics used in modern anesthesia are drugs that have minimal effects on the human body and are reversible, and can be completely excreted by the body’s metabolism after surgery. As for the phenomenon of temporary poor mental health or drowsiness in the process of waking up from anesthesia after surgery, they are some normal reactions.
Terminology;
Anesthesia originally means the temporary loss of sensation of the whole organism or a part of the organism of the patient by means of drugs or non-drugs, in order to achieve painlessness; anesthesia was originally intended to relieve the pain produced by the surgical process, but with the continuous development of modern medicine, anesthesia is also constantly updated and changed.
Nowadays, anesthesia in medicine has gone far beyond the purpose of simply solving surgical pain relief, and the scope of work is not limited to the operating room, thus the concept of anesthesia and anesthesiology has a broader meaning. It not only includes anesthesia analgesia, but also involves the preparation and treatment of the whole perioperative period before and after anesthesia, in order to maintain the physiological function of patients, provide good conditions for surgery, and guarantee that patients can safely pass through surgery. In addition, it also undertakes emergency resuscitation of critically ill patients, respiratory therapy, shock treatment, pain treatment, etc. The footprint of anesthesia workers involves the entire hospital and other sites.