I was preparing to perform cervical plexus anesthesia on a patient, but I lost my focus and went in the wrong direction. I could only silently use general anesthesia to make up for it.

In recent years, due to the rapid development of the concept of accelerated postoperative recovery, the concept of anesthesia has also kept pace with the times. Moreover, it has become one of the key factors in the concept of accelerated postoperative recovery. Among them, combined anesthesia has become a powerful tool for anesthesiologists to control anesthesia.

(The picture and text are unrelated)

Learning makes me happy

The photos are from the 3rd "Renxin Cup Most Beautiful Angels in White Photo Collection Competition"

Photographer: Tao Yunsheng, Anqing Navy Hospital

From the perspective of the industry, the rise of ERAS may be related to the increasing number of surgeries. The most direct problem is the shortage of beds. In large tertiary hospitals, it is almost always difficult to find a bed. Therefore, how to get patients out of the hospital safely and quickly has become a consensus goal.

On this day, Xiao Wang, who was in charge of anesthesia, was in charge of general surgery anesthesia. Looking around, it was either thyroid or breast surgery. There was an appendectomy in between, but it did not affect the overall situation.

Seeing so many surgeries, Xiao Wang thought to himself: I can’t waste time. If I waste time, not only will I not be able to get off work, I may have to “work late into the night”.

The progress of the surgical operation cannot be controlled, so we can only work on anesthesia. Since the maintenance phase of anesthesia must cover the entire operation, we can only speed up the two phases, the beginning and the end. In general, we have to "get anesthetized quickly and wake up quickly."

Especially, "waking up quickly" is the most difficult. If the patient wakes up slowly due to various reasons, the whole process will almost be ruined.

It's like figure skating, no matter how well you skate, a failed quad jump is enough to lose the gold medal.

In order to ensure that the patient's awakening is "safe and sound", Xiao Wang always tries to use a combination of regional block and general anesthesia.

Combined anesthesia, in simple terms, is the use of two or more drugs or techniques to complete anesthesia. Through this combination, the disadvantages can be reduced and the advantages of both can be brought into play.

However, in a rush, he injected most of the drug into the side that was not being operated on.

Since the total amount of anesthetic is limited, taking too much will cause poisoning, so we had to give up in disappointment.

During the operation, he could only accurately adjust the various drugs for general anesthesia.

As for the cervical plexus anesthesia, it was effective but not obvious, so he crossed it out from the billing items.

The operation was over and the patient woke up on time. He shook off his previous gloom and continued with the next anesthesia.

In fact, from an academic point of view, there is nothing wrong with what he did. Even if he charged for the cervical plexus anesthesia, it was normal. Because his superficial cervical plexus block was bilateral, but the deep plexus block was done the wrong way. Waking up "on time" after the operation was also partly due to this seemingly "mistaken" operation.

A quick note: Deep plexus block is mainly used to control pain transmission during surgery when treating the deep part and upper pole of the affected side of the thyroid gland. If the effect is good, the amount of medication used during surgery will be reduced a lot. Reducing the amount of medication means that the possibility of a smooth postoperative recovery is greatly increased.

As for the deep plexus block, we recommend that it is best not to use it. If you want to use it, try to do it under visual conditions. After all, deep plexus block may cause many complications. Under general anesthesia, many abnormalities that should be manifested may be concealed.

[Warm Tips] Follow us, there are a lot of professional medical knowledge here to help you understand the anesthesia issues in surgery~