The patient kept shaking his legs. The doctor was about to get angry, but after taking a pill, he found that it was a disease.

Normally, it is the interns who see the patients who will be operated on the next day. If they encounter a difficult problem, they will promptly consult the superior physician. But then again, these interns who are either undergraduates or postgraduates are all OK. Generally, they do not call the superior physician.

However, Dr. Li, who was in charge of the visit, called the senior doctor a few days ago. She reported that the patient was a little disrespectful and hoped that the senior doctor would intervene. In this way, the senior doctor went with a hundred reluctances.

After seeing the patient, the senior doctor felt that the matter was not that simple: the patient was indeed shaking his legs non-stop and seemed a little impatient, but this movement should be involuntary. Think about it, the senior doctor is here, a normal person would have to control himself! If he continues to disrespect medical staff, it will be difficult to establish a basic doctor-patient relationship.

After the "simple" conversation, the senior doctor couldn't tell whether the patient did it on purpose. The reason why it was "simple" was because the patient seemed quite sleepy. It looked like he was about to fall asleep. So the two of them could only withdraw reluctantly.

After learning about the situation from the surgeon, they felt something was wrong. Because this person was shaking his legs all the time. When they asked the nurse, she even exaggeratedly said: He also shook from time to time when he was sleeping. But as soon as they approached him, he woke up immediately. Therefore, they did not dare to ask in detail.

At this point, the senior doctor suddenly thought of a disease - restless legs syndrome.

He didn't know much about this disease, so he quickly took out his phone to look up information.

After seeing the detailed introduction of this disease, I can't help but worry about the anesthesia for this operation. According to the information, restless legs syndrome is also known as restless legs syndrome, which is a neurological disease. Since it is a complication of the nervous system, it must be taken seriously. Because anesthesia cannot just numb the patient, but also wake him up.

People in the industry know that it is easy to be anesthetized but difficult to wake up. It is no exaggeration to say that anyone with a normal IQ can be taught how to anesthetize someone in a short time. However, waking up requires a combination of drug efficacy, pharmacokinetic factors, the patient's physical condition, environmental changes during the perioperative period, and many other factors. Only by accurately grasping these factors can the patient wake up smoothly.

Assuming that the patient suffers from restless legs syndrome, it is likely that a series of problems will arise due to associated insomnia, anxiety and even cardiovascular problems.

When asked about his medical history, he could not find out why. He said that his father seemed to have had leg shaking problems as well. However, he had passed away many years ago, so he could not be sure.

Speaking of this point, it happens to hit the mark in the data: half of the primary patients will have a positive family history.

However, this does not mean that the patient is sick. The problem is that such patients cannot be diagnosed by general examination methods. Although polysomnography (PSG) and suggestive immobilization test (SIT) can help diagnose suspected cases, it is still difficult to confirm the diagnosis. Moreover, the surgery has been put on the agenda, and there is not much time to do this experiment.

Thinking of this, the senior physician came up with a bold idea: to use drug testing.

What medicine? Everyone asked in unison.

Weak opioids, the senior doctor said.

Before anyone could ask more questions, the senior doctor continued: If he has restless legs syndrome, his symptoms will be relieved or even disappear after taking medication.

In order to dispel everyone's concerns, he also said humorously: "The anesthesiology department will use some painkillers, you won't be so worried, right?" Besides, this medicine can also help him sleep well.

After everyone agreed, we got down to work. We communicated with the family and prepared medicine and monitoring methods.

Although I had already left work, no one would feel at ease to leave work without understanding this patient. So, an experiment of testing and treatment began. The test was to see if he had restless legs syndrome; the treatment was for his insomnia, which he had suffered from for many years. At least, let him have a good sleep before the operation. This would be good for the stability of the circulation during the perioperative period.

After taking a dose of medicine, the two legs that had been shaking constantly calmed down.

As he had been suffering from insomnia, he soon felt sleepy after coming across such a good medicine.

Since the medication was in a safe dose, he was allowed to continue sleeping after proper monitoring.

The next day, after a good night's sleep, he went to the operating table feeling more relaxed than ever before.

At this time, the senior doctor said: For such patients, be careful of delayed awakening. Because his nervous system is problematic, it is possible that the cerebral cortex responsible for awakening will sleep in. He had a good sleep before the operation, so the possibility of delayed awakening has decreased. However, the most important thing is close monitoring during the operation and precise medication regulation.

Beside them, the trainee nodded frequently.

To help everyone identify this disease, we summarize the clinical manifestations of restless legs syndrome:

The disease is often characterized by deep discomfort in the lower extremities and the desire to move the affected limbs. The deep discomfort in the lower extremities is often described as a crawling sensation, burning sensation, creeping sensation, tearing sensation or pain. It is often bilateral or symmetrical, occurring mainly in the knees and ankles, but can also affect the thighs or feet; the arms can also be involved. But it often occurs years after the symptoms in the lower extremities appear.

More than 50% of patients complain of pain, and some patients only have a strong desire to move their legs without any abnormal sensations. The desire to move the affected limb or the feeling of discomfort in the leg often appears or worsens when resting, and can generally be relieved by exercise; the symptoms can also be relieved by stimulation such as leg massage, hot or cold water baths.

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