Mrs. Zhou is 87 and has never been to a hospital in her life. In her impression, she seemed to have been to a health center when she was a few years old. However, in the end, no one can escape from life and death. Not long ago, she slipped and fell accidentally, and she was admitted to the hospital. Not only do we have to stay in the hospital, but the doctors say we have to have a major operation.
she begged the doctor to say “don’t operate”, but the doctor told her that “it’s impossible not to have surgery”. She also urged the doctor to give her some plaster on the line, the doctor was happy: This is impossible.
it’s no wonder that Mrs. Zhou has a fracture of the femoral head, which is difficult to heal because of the blood supply disorder caused by the fracture. If it doesn’t heal, stay in bed for a long time. For an elderly person, bedridden is the countdown to life.
with the time of convalescence, the function of various organs has been rapidly reduced. Therefore, doctors are right to suggest active surgery. Moreover, folk prescription has no scientific basis and can not be used in hospitals. Therefore, the doctor can only refuse her request to use folk prescription.
before the operation, she specially called the main family members to the bed. Left advice, right advice, like the last farewell. All her life, she had never been to the hospital, and she was terrified.
seeing this blood pressure, everyone turned to Dr. Liu in the Department of anesthesiology. At the moment, Liu’s decision will determine whether the operation can be performed. Even, it may determine the fate of Mrs. Zhou. This is because, according to the requirements of perioperative management, blood pressure needs to be controlled in an ideal range. At least, it’s not like 200 now. This means that as long as the anesthesiologist says no, it needs to be pushed out to adjust blood pressure. Wait until the blood pressure is good, and then the operation.
However, once it is pushed out, blood pressure is generally adjusted, ranging from three to five days at least to ten and a half months at most. Despite the fact that there are only a few days, studies have shown that two or three days in bed is enough to produce pneumonia. Once the fall of pneumonia, Mrs. Zhou is likely to lose the chance of surgery forever. Just imagine, now this tense doctor-patient relationship, which doctor dare to take this risk?
when Dr. Liu tried to find a way out, everyone gradually realized that the New Doctor Liu was different. In my impression, not long ago, he also gave a lecture on orthopedic anesthesia for the elderly. Among them, the concept of “the last fracture in life” is also emphasized. For the last time, it doesn’t mean that you will never fracture again, but you will never have a chance to fracture again.
after five minutes, Dr. Liu, who was staring at the monitor, motioned to everyone to help him turn the patient over and put him in his position. See here, everybody’s heart is cool again. After watching for a long time, it is still the established half body anesthesia before!
Why are we not excited? This is because half body anesthesia is bound to cause a sudden drop in blood pressure. If you encounter with insufficient blood volume and poor cardiac function, it is very likely that life-threatening situation will occur.
careful people will find that Dr. Liu’s medication seems to be different this time. Not only a very low concentration of ropivacaine was used, but also sterile water for injection was added to the anesthetic.
after the anesthesia puncture was completed, a surprising scene appeared. Mrs. Zhou, who used to hum, stopped humming and even took a nap. Not only that, when orthopedic doctors put their positions, Mrs. Zhou could follow the doctor’s strength and move her legs.
it was not until the moment when the scalpel cut the skin that Mrs. Zhou didn’t respond, and the orthopedic doctor’s heart was still hanging. People around, each busy their own, the operation is going on.
afterwards, the orthopedic doctor asked curiously: your anesthesia is amazing. It’s the first time you saw such anesthesia. Liu told him with a smile: anesthesia technology has entered the era of precision, if conditions permit, even single nerve anesthesia. This time Mrs. Zhou’s anesthesia, on the one hand, made use of the advantages of unilateral anesthesia, on the other hand, the motor sensory separation of ropivacaine itself also contributed. This kind of anesthesia can not only accelerate the recovery of patients after operation, but also the circulation during operation is extremely stable.
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3. Fan Linbin. Clinical study of light specific gravity liquid unilateral spinal anesthesia in elderly patients with lower limb surgery [J]. Journal of Mathematical Medicine, 2018, 031:497-498.08/16/2020