Matters Calming conversation with the patient - and if this child, then his parents (or their concerns be passed child and it will be harder to fall asleep). The day before surgery the anesthesiologist comes in and tries to maintain a conversation in his ward. He gently explains that happen and why you should not be afraid of the operation. Again, it is important not to nervous and parents.
But the patient is in an operational unit. Half an hour later he was ready for surgery. During this time he may be in deep sleep or be awake but in any case he should not feel pain. The method by which to reach the desired state of operation is called ...
Anesthesia is general , regional and local .
general anesthesia - a well-known "anesthesia . Immersion in the anesthetic is tase. First, in the vein of the patient is fed a dasg-hypnotics. Blood is a hypnotic molecules to the brain. The brain reacts to the dasg, and soon there comes a deep medication sleep. The patient will sleep until the end of surgery, and when he wakes up, everything is left behind.
consciousness of the patient is disabled, but muscle can still contract in response to the actions of surgeons. To surgeons could safely work the muscles have to immobilize the patient. It makes special substances - muscle relaxants, which block the transmission of impulses from nerve to muscle.
However, even in deep sleep and being immobilized, the person still feels pain. Therefore, the operation can proceed only after the third stage of anesthesia - anesthesia. Pain impulses in the anesthesia can block or narcotic analgesics or anesthetics. Narcotic analgesics, serves a patient "through the vein. Gaseous anesthetics - through a mask; they are used only for operations lasting nomorethan a half hour.
"pumped up" hypnotics, muscle relaxants and pain medications the patient is already on what not to respond. Hence, we can proceed to surgery.
Regional anesthesia is so called because they relieve only a portion of the patient's body. When central Regional Anesthesia relieve large areas of the body (eg, the lower part of the body). When peripheral - a small area: arm, leg, hand, foot. But in fact, and in another case, the principle one. Solution of local anesthetic injected into the area around the nerve bundle, blocking pain impulses conduct. In this case, most often blocked by not one, but a lot of nerves, each of which is responsible for its zone.
When the central regional anesthesia dasg is introduced directly into the spinal canal, affecting the bundles of nerves that go directly from the spinal cord.
Applying this anesthetic, one can do without a complete immobilization of the patient and, in principle, even without diving into a dream. However, the procedure itself is pain unpleasant, and sometimes even painful. And for the child she is also hard to bear because he was not persuaded to lie still for several minutes. In addition, during surgery, the patient will hear everything. Hence, it is better to euthanize him.
Topical anesthesia used only for small surgical procedures (eg removal of moles), and only with the consent of the patient or his parents. Dasgs used are the same as that for regional anesthesia. Only in this case is not blocked by large nerve bundles, and the pain receptors in the intended use. Such pain relief make themselves surgeons, but always in the presence of an anesthesiologist.
There are areas of surgery where anesthesia - the only possible method of anesthesia. This is neurosurgery, cardiac surgery, vascular surgery, thoracic surgery (surgery of the chest) - the hardest intervention, in which need complete control over the patient.
In less complicated cases, your doctor selects the method of anesthesia, at its discretion, taking into account Of course, the patient's condition. Someone thinks that the best general anesthesia, someone is sure that the future - for the regional. Third, to which is the author, believe that it is necessary to combine these methods, thereby reducing the use of narcotic and hypnotic dasgs and thus harm to the body.
In During the operation the anesthesiologist carefully monitors the concentration in the blood levels of dasgs administered intravenously. If the concentration becomes higher than the maximum allowable, can stop the heart. In this case, the anesthesiologist immediately makes the chest compressions. In most cases, the heart returns to normal operation.
While there is a surgery, the anesthesiologist is constantly at the patient's head. It supports anesthesia or checks whether adjacent sealed mask. Monitors the performance of devices and monitor are connected to the patient - for blood pressure, heart rate, body temperature, blood oxygen saturation.
Of course, he can not predict what difficulties he would encounter. If the situation threatens the life of the patient, the anesthesiologist and the surgeon stopped the operation.
serious (life threatening) complications during the surgery a lot - heart failure, lung injury, fever, and so on. But they rarely happen.
If all goes well, the patient comes out of anesthesia after surgery. Back reflexes, muscles begin to shrink, there is spontaneous breathing. The anesthesiologist must establish contact with the patient - to talk to him, ask him to open his eyes and answer questions.
After the patient came out of anesthesia, it is sent to the department, and if the operation wasmorethan three hours, then in the intensive care unit, where he finally wakes up. Since he alone still can not breathe, then mechanical ventilation continues.
in his ward brought sleepy: in the body remain dasgs-hypnotics. Get out of bed until awakening is impossible. After anesthesia vestibular apparatus is not in order - a man badly coordinated their movements and may fall. Therefore it is better to lie to the full recovery of consciousness and control of the body.
completely harmless and safe method of anesthesia there. Dasgs for narcosis is very heavy in the liver (which removes them from the blood) and damage liver cells. If the same patient must be immersed in the anesthesiamorethan once a month, he may develop jaundice, and eventually cirrhosis. Extracts and the cardiovascular system, particularly the heart. Some of the anesthesiologist may lead to injury - for example, careless introduction of the tube into the trachea for ventilation.
When regional anesthesia is usually used hypnotics (to "turn off" the patient "), which negatively affect the body. In addition, this method has its complications. During local anesthesia can damage the nerve with a needle, which is why a certain part of the body on time can lose sensitivity. And when hit anesthetic in the blood can start cramping and even temporarily stop breathing.
Yet regional anesthesia is less dangerous than general anesthesia, but its use is limited for several reasons. This and stereotypes, and are not always trained staff, including nurses. The use of many dasgs, anesthetics for children does not permit Farmkomitet Russia. And in the work of the anesthesiologist, the law - which is not allowed, is forbidden. The annotations to local anesthetics prescribed age of the patient - usually of 12 years. " That is, children under 12 years, most local anesthetics is not shown. And not because they are harmful, but because it is not fully understood. Therefore, for children under 12 years of anesthesiologists have to use dasgs with a small period of validity (up to six hours). And if the operation lasts longer have to do anesthesia.
Local anesthesia is not as harmful to the body as a regional or general - of course, if there are no complications. Among them - an allergy to the dasg, getting the dasg into the bloodstream. In addition, surgeons (particularly children) are not very fond of local anesthesia - in fact the patient is conscious and can see the whole operation. That sometimes makes him a shock, leading subsequently to a mental disorder.
In medicine, there is no harmless dasgs. If you are told that the dasg is harmless, it does not work - it's the law. Body - a complex system with lots of adjustable parameters. Any medication to something so adversely affected.