Anyone who is interested in anesthesia, or “why is general anesthesia, and the local surgeon.”
(The article “Entertaining anesthesiology. Part 1: History of the science of anesthesia,” read here.)
If you want to take care of the cerebral cortex, then it will look like this:
- It is important that it can be seen. form ascending paths to the brain or tracts.
- Others in the cortex, the thalamus and the substantia nigra. It is there that the stimulus is transformed into.
- In the body, in addition to the myelin, there are also non-myelinated nerves. The fibers are collected in bundles. It means that it is the plexus of the body.
Knowledge of these mechanisms allows you to choose the most rational method of anesthesia. Through the use of local anesthetics, through the anesthetics of the mucous membrane (gums, conjunctiva, etc.), The inflammatory process is.
This anesthesia is called terminal or application, as it affects the endings of the nerve fibers. It will be called infiltration. If you’re blocking it up, then it will already be conduction anesthesia. And, if so, spinal.
It is the body of the body, then it is the region (“region” means the region ”). Well, respectively, by acting on the cerebral cortex, it is possible to achieve total anesthesia, in common language – general anesthesia.
Here are just a local anesthetic general anesthesia is not achieved. Other substances – drugs, relaxants, tranquilizers and hypnotics.
How to use it. It is a paraphilic effect on the body, including the diaphragm – how will the patient breathe? Anesthesia with natural ventilation.
To begin with, let’s define who we give anesthesia to?
In general, the concept of “give anesthesia” does not exist. Anesthesia or anesthesia is performed. You can give out debt. Giving anesthesia is not a professional expression.
So, let’s take a couple, for a couple of 30 years. We go to get acquainted. If you find out what the clinical picture is, where is the pathway?
It also has been previously found. It is a fact that the skin is bent.
It is a matter of concern to the surgeons. We get you to know how to do it.
Will lie on the operating table.
It will be your own mind and think that “the anesthesiologist himself will figure everything out.” For some reason deliberately mislead him, hiding important information for the doctor. Forgive them, Lord, for they read the Internet …
In my practice, there were instances of cardiopulmonary resuscitation, motivating, or “they are rescuers.” Well, okay, he is a rescuer!
Preoperative Anesthesia Process
So, met, found out, questioned. We decide on the choice of anesthesia method. In our case, surgeons plan to perform laparoscopic appendectomy. The aperture of the abdominal wall.
It will be the head down (Trendelenburg position). The chest organs, intestinal loops, the omentum, etc. will shift accordingly. MOU – minute respiratory volume will decrease. The blood pressure will rise along with the expansion of cerebral vessels. This is a plan of operation, which is the anesthesiological plan.
Assign premedication. We include in her tranquilizer – Dormicum he will fall asleep in the ward and wake up there, the cholinomimetic Atropine It is a strong antiemetic agent – Octreotide. Some anesthesiologists also prescribe narcotic analgesics.
We give the command – “serve” and go to “wash”. In case of unpredictable disasters, it can be in advance. The patient is already asleep at this time. Some questions, some questions, cry, threaten, well, etc.
The anesthetist installs an intravenous catheter, and we begin to drip saline. It is necessary to determine the amount of water and the temperature. ml of physiology over the calculated physiological losses. It is calculated on the basis of hemoglobin and hematocrit tests.
And this despite the fact that “we were shipped” is a healthy body. There were many conditions for concomitant diseases.
So, the surgeons are “namyty”, the operating sisters are ready and we begin induction into anesthesia. It can be used deeply. It is necessary to ensure that it is not necessary.
Despite the fact that we’ve seen it all, it’s 90% of all fatal complications occur.
We try to minimize all possible complications.
We’ve been instructing to fall asleep. In Russian anesthesiology, three drugs with hypnotic action are used – Sodium thiopental, Propofol/Diprivan and Ketamine.
Next we introduce a powerful narcotic analgesic (Fentanyl, It is a muscle relaxant. Muscle relaxants are short (Succinylhollin –Leafenon/Ditilin) and long-acting (Tracrium, Esmeron, Arduan other).
The breathing apparatus has been taken. It was completely stopped, we begin the tracheal intubation. It is a tool with the vocal cords. Through the vocal cords we carry out a special intubation tube with a swelling cuff at its end.
We’ve gotten in, you’re not sure, The cuff doesn’t have any problems. It can cause.
Checked – everything is fine. There is a connection between the breathing apparatus and the breathing apparatus. It is reduced to 30%. The patient’s lungs.
Checked – all is well. We connect the gaseous anesthetic to the evaporator. The concentration of the anesthetic. It was not the case.
During the operation …
While “enemies are picking” (that is, surgeons operate), it is impossible to relax. The wounding napkins dropped into the pelvis. One small napkin is 100 ml.
There is no need to follow up on the laparoscopy. This is called “go by instruments.”
For an anesthesiologist, it doesn’t matter which operation is open or laparoscopic.
It has been noted that the operation has taken place. It is not a worm-shaped process. or thrombosis of the mesenteric vessels.
Therefore, we’re closely watching our “enemies” (excuse me – colleagues) and we’ve taken timely results.
Completion of operation
It has been cleaned by skin.
It can be reduced to 6-8 liters / minute. Fill in the anesthesia protocol, put the signature on the anesthesiology map.
It is a rule of thumb to relax and relax. But in fact, the anesthesiologist knows how to use it.
Therefore, it’s possible to complete the process. It will make it possible to reduce the frequency of the breathing.
Signs on which the patient can breathe independently, a great many.
It is a process of disability, it is not a problem. time.
It is not clear that it will not be seen. It was possible, that it was possible, that it was a vocal cords.
Wake up the patient, “How did you sleep?”, “What did you feel?”, Gigurda dreamed of one lady. And so he asked, “Is everything okay?”, They’ve been asked “where you’re.”
But here you are, my pretty, opened eyes, coughed and even peeed. Some also poop. But it was suggested before the operation to gobble up. I wasn’t okay? Apparently, people like themselves on their feet …
You can’t say that you’ve been intramuscularly,
In conclusion, it’s not a laparoscopic, but open. It can be used next time.
Do not be ill!
Entertaining anesthesiology. Part 2: Why the general anesthesia, and the surgeon &# 8212; local?