Intravenous anesthesia is to inject a certain amount of anesthetic through intravenous injection. Because this anesthesia has a low depth of anesthesia, it is only suitable for superficial and short surgery. During the operation, the patient still retains his own rest, but does not feel conscious.
According to their anesthesiologist, this anesthesia is a routine procedure. It is true that the anesthesia methods in each hospital are slightly different.
At present, most provinces and cities use sacral canal anesthesia for anorectal surgery, followed by intra-spinal anesthesia, intravenous anesthesia or local anesthesia. In short, they are all technical characteristics gradually developed based on the actual situation of their own hospital.
So, what happened to this anesthesia?
has laryngeal spasm!
No anesthesiologist is unfamiliar with laryngeal spasm. Even if I have never experienced it myself, no one dares not not recognize this complication. Because, this complication is very dangerous. If the situation is not lifted in time, serious consequences such as respiratory and cardiac arrest are likely to occur.
This laryngeal spasm occurs when the anorectal department has begun its operation. At this time, the anesthesiologist had given intravenous anesthetics.
Considering that the patient may have problems with long-term smoking and respiratory system, the anesthesiologist controls the anesthesia to a relatively shallow state. Assuming that a situation occurs, the patient can recover in a short period of time.
However, this already routine operation has occurred: a patient who was breathing smoothly suddenly had apnea. After careful observation, the airway obstruction is highly suspected.
immediately inserts into the oropharyngeal ventilation duct without relieving it; pressurized ventilation seems to have no effect.
Although the situation has just passed and the value of blood oxygen has not yet dropped, the anesthesiologist knows that the risks in front of him are related to life and cannot be delayed for a moment. So, while asking the nurse to help call the anesthesiologist next to him, he worked hard to increase pressure and provide oxygen.
At this time, he judged that the patient had laryngeal spasm.
Looking at the tracheal catheter on the anesthesia table, he thought to himself: If it does not relieve it, tracheal intubation will be intubated.
Previous experience or theories, most of the pressure ventilation can be relieved after laryngeal spasm.
At the same time, his brain rotates at high speed: high airway response? Sputum stimulation? Cause of hypoxia? …
As one of the suspects was excluded, he noticed that the anorectal department on the stage was still continuing to operate. Could it be caused by anal expansion? Thinking of this, he was shocked.
Anorectal department did not notice what happened on the anesthesia side, and it was still continuing to expand the anus.
This patient, due to repeated hemorrhoids, has caused his anus to be very narrow. In order to achieve the quality of life in the future and to obtain better surgical conditions, the anorectal department has to work hard to expand the anus.
Hearing the anesthesiologist shouting to stop, the anorectal doctor realized that something was wrong, so he stopped and took a detour to observe the head.
At this time, the anesthesiologist found that the blood oxygen had begun to move downwards and the signs of laryngeal spasm did not seem to be relieved. Therefore, I picked up laryngoscope and started tracheal intubation while staying in the lateral lying state.
The colleague who came here did not need to ask the reason, and immediately helped fix the catheter and connect the anesthesia machine.
The anesthesiologist who took a breath and said in fear: The glottis is tightly closed and the tracheal catheter is barely passed, so it can be confirmed that it is laryngeal spasm.
Due to the crisis, the anorectal department continued the surgery. Anesthesiology Department , the two continued to analyze.
below is professional knowledge for professionals to read.
laryngeal spasm and bronchospasm are commonly found in patients with asthma , chronic bronchitis , emphysema, allergic rhinitis and other patients. The airways of such patients have a high sensitivity response to foreign body stimulation, which is related to the abnormal autonomic nerve regulation of the airway and the release of certain biochemical mediators.
Laryngeal spasm is a manifestation of hyperactivity of the protective reflex of the respiratory tract. It is one of the serious complications of anesthesia. It is clinically manifested as inspiratory dyspnea, which may be accompanied by high-profile inspiratory wheezing.
Under normal circumstances, the glottic closure reflex is to close the glottic closure to prevent foreign objects or secretions from inhaling into the airway.Laryngeal spasm is caused by the increased excitability of vagus nerve that control the pharynx, which increases the stress in the pharynx and increases the glottic closure activity.
So, under what circumstances does laryngeal spasm easily occur?
laryngeal spasm mostly occurs at the depth of stage general anesthesia Ⅰ-Ⅱ. The inducement is hypoxemia , hyperCO2emia, oropharyngeal secretions and reflux gastric contents irritate the throat. Oropharyngeal ventilation duct, direct laryngoscopy, tracheal intubation operation, etc., which can induce laryngospasm.
Surgical procedures such as dilating the anal sphincter, peeling the periosteum, pulling the mesenteria and gallbladder can also cause reflex laryngeal spasm.
Here, there may still be many friends who do not understand the relationship between anal expansion and laryngeal spasm. From the perspective of embryonic development, the throat and anal canal develop from the same part of the embryo. Is this inspiring to everyone?
Finally, I want to say that there are only minor surgery but no minor anesthesia!
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