After connecting the patient to a monitor, adjusting the oxygen level, and hanging a bottle of fluid on the indwelling needle for emergency treatment, the nurse walked away, leaving the anesthesiologist alone to operate the procedure.
The anesthesiologist needs to give the patient anesthesia. For patients like this who have surgery on the anus, the doctor has written that general anesthesia is not required. If general anesthesia is not required, it should be avoided as much as possible. General anesthesia has high risks and is expensive. With these two disadvantages alone, anesthesiologists and surgeons do not like to use it. This is something that ordinary people do not need to worry about.
My supervisor told me to give the patient spinal anesthesia, which is a type of spinal anesthesia.
The teacher gave instructions, and the interns followed the teacher's instructions. As an intern, Liu Jingyun was more cautious. She first checked whether the rescue equipment was in place, such as the tools for tracheal intubation and whether the defibrillator was on hand.
Open the anesthesia puncture kit and check whether all the items inside are complete. Use a syringe to draw out the anesthetic and saline solution respectively.
While doing these things, Liu Jingyun forgot that his junior sister was beside him, and his mind was only filled with thoughts about how to proceed step by step.
During spinal anesthesia, the patient has to lie on his side. Xie Wanying helps the senior sister adjust the patient's position. Since she is here, she must help the senior sister.
The patient should bend his head down, hug his knees with his hands, open the lumbar intervertebral space, and make his back flush with the edge of the operating table. This will help the anesthesiologist to operate.
However, the patient did not receive anesthesia. When she was just asked to lower her head, she cried out that she felt uncomfortable. When she was asked to hug her knees with both hands, she said she could not do it: "My waist hurts so much!"
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After hearing this, whether you have studied medicine or not, you will know that something is definitely wrong.
"Senior Sister." Xie Wanying called her Senior Sister.
In fact, Liu Jingyun heard the patient crying out in pain, and his heart sank to the bottom of the sea.
Dr. Zhang hates it most when interns turn around and call him.
Liu Jingyun is in the eight-year program, which has an additional internship period than the five-year undergraduate program, so now she can basically operate on her own, and the teacher will only come to inspect and supervise.
This simple spinal anesthesia is not even a combined spinal-epidural anesthesia, nor is it the more complicated epidural anesthesia catheterization. It only needs to accurately penetrate the two layers of dura mater and arachnoid membrane to reach the subarachnoid space and inject anesthetics. It is a relatively simple spinal anesthesia.
Subarachnoid anesthesia takes effect very quickly, and the anesthesiologist can easily judge the effect of anesthesia. In the eyes of the teacher, it is not a difficult operation.
Nowadays, there are more and more anesthesia methods, which need to be combined with more advanced surgical methods. Spinal anesthesia is widely used. It is a threshold for anesthesiology students, but for working anesthesiologists, especially anesthesiologists in top tertiary hospitals, it is a job that can be done with a small salary.
It is unacceptable that while interning in the anesthesiology department of a top tertiary hospital, you cannot even perform simple spinal anesthesia through spinal anesthesia.
Adjusting his mentality, Liu Jingyun turned around, walked to the patient, and asked: "Where does it hurt? Tell me?"
"I can't bend down." said the aunt.
Can’t bend down, lumbar disc herniation?
Modern people lead fast-paced lives, and many people have various minor illnesses. Lumbar disc herniation is a common disease. If spinal anesthesia is not possible in such a situation, then spinal anesthesia would have been eliminated by all anesthesiologists. Therefore, lumbar disc herniation is not the key factor in whether spinal anesthesia can be performed.
Spinal anesthesia is usually performed at the second or third lumbar spine, and lumbar disc herniation is most common at the fourth or fifth lumbar spine, so it should not be a big problem.
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