People who can drink a lot can’t get drunk or fall asleep?

The day before the operation, the anesthesiologist will visit the patient in the ward, assess the anesthesia risk, and sign the anesthesia informed consent form. When visiting the patient, the doctor will ask the patient whether he drinks alcohol. At this time, some patients will say: Doctor, I can drink a lot of alcohol. I can drink a pound of liquor in one meal. People say that drinking can make me resistant to anesthesia. You have to give me more anesthetics, so that I can be anesthetized and unable to sleep. So, what is the connection between alcohol and anesthesia? Is it true that a "drunkard" who can drink a lot of alcohol is not easy to be anesthetized?

Well, let us, the anesthesiologists, explain to you the relationship between alcohol tolerance and anesthesia.

Alcohol tolerance, as the name implies, is the maximum amount of alcohol a person can drink. The amount of alcohol tolerance mainly depends on the absorption and metabolism of alcohol. Studies have shown that an average adult can only metabolize 10 ml of alcohol per hour, and the maximum amount of alcohol that can be metabolized within 24 hours is 450 ml (about 1.8 jin of 50-degree liquor, 2.3 jin of 38-degree liquor). As drinking increases, the increase in alcohol plasma concentration can cause impaired consciousness and motor function, causing vestibular, cerebellar and autonomic nerve dysfunction. When the concentration is greater than 500 mg/dl, it can cause obvious respiratory depression or even death. Excessive drinking has no benefits, so don't drink too much even if the wine is good!

What is alcohol absorption and metabolism

1. Absorption of alcohol.

After drinking, alcohol quickly enters the blood through the capillaries of the stomach and small intestine.

2. Metabolism of alcohol.

Alcohol is mainly oxidized and metabolized by the cytochrome P450 enzyme system in the liver, and is finally excreted from the body in the form of water and carbon dioxide.

People who drink a lot and drink for a long time will have an increase in "P450" in their bodies. It happens that cytochrome p450 enzymes are important members involved in the metabolism of anesthetics, which means that for patients who drink a lot and drink for a long time and undergo surgery, the metabolism of anesthetics will indeed increase. Therefore, for patients with a large alcohol tolerance, because the liver enzyme system in the body is more developed, the dosage of anesthetics should also be increased when using anesthetics. Of course, the premise is that these drugs need to be metabolized by the liver, otherwise this effect will be very small.

Commonly used anesthesia methods can be divided into regional anesthesia and general anesthesia according to the body part. Long-term and heavy drinking generally does not affect the anesthetic effect for patients who need regional anesthesia (local infiltration anesthesia, peripheral nerve block, and spinal anesthesia). The main thing affected is general anesthesia. For patients with general anesthesia, in addition to anesthetic sedatives, there are three major categories of anesthetic drugs including analgesics and muscle relaxants. They complement each other and work together to complete the anesthesia process. Therefore, the effect of a small number of drugs due to drinking is not enough to shake the overall effect of anesthesia. The anesthesiologist will adjust the dosage of anesthetics according to individual conditions. This is the most basic technology. Therefore, it is only necessary for the anesthesiologist to implement the anesthesia plan correctly and reasonably, and the situation of "not being able to fall down" and "not being able to sleep" will never occur.

In short, the amount of alcohol you drink has a certain impact on anesthesia, but the anesthesiologist will make a comprehensive judgment based on your specific situation and develop an anesthesia plan that suits you personally, ensuring the anesthesia effect while protecting the safety of the patient throughout the entire operation. Remember that drinking a little can make you happy, but drinking too much can hurt your body. If you need anesthesia for surgery, remember to tell the anesthesiologist your drinking history and alcohol tolerance, which are very important for the safety of anesthesia and surgery.

Shen Li, Department of Anesthesiology, Zhengzhou Second People's Hospital

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