The doctor said "I'm sorry" and then pried open the patient's eyes.

Dr. Tang was on duty on Sunday, so the preoperative visits for all the surgical patients on Monday fell on him.

As I finished filling out a thick stack of visit forms, a feeling of impending victory came over me. Before I knew it, I had arrived at the general surgery ward for a patient in his 80s.

Seeing this age, Dr. Tang immediately became alert: performing surgery at such an old age cannot afford mistakes. Especially during the visit, he must not make any mistakes in front of his own class.

After reading the medical records, he felt relieved because, despite the patient's age, there was nothing wrong with his medical records.

Some people argue that an electrocardiogram can show irregular heart rhythm.

When people are over 80, their organs generally undergo degeneration. This type of arrhythmia is actually a form of degeneration.

However, when he came to the patient's bed, he was a little nervous. Because the patient had no idea that he was here for a preoperative visit. It was not until he almost shouted the old man's name that the old man turned around, but did not open his eyes.

Although the whole society advocates respecting the elderly and loving the young, he still had some thoughts when the old man ignored him. He thought: No matter what, I am here to treat you, I can't treat people like this!

Afterwards, the old man seemed to fall into a deep sleep again and did not answer his questions.

When he saw the doctor coming, he hurriedly said: I'm sorry, the old man's hearing is not good, just ask him if you have any questions.

At this point, Dr. Tang finally figured out that the old man had hearing problems.

But, we can't not open our eyes, right?

The old man's family members seemed to understand what Dr. Tang meant, and hurriedly said: The old man's eyelids are too loose and it is difficult for him to open his eyes. Only when he tries hard to open his eyes can he barely open a crack.

Hearing this answer, Dr. Tang was a little worried: How can a person wake up after general anesthesia if he can't hear or open his eyes? You can't pinch him, right?

But when I thought that I wouldn’t have to anesthetize myself the next day, I felt a little relieved.

Unexpectedly, the director saw that this patient was special the next morning and directly arranged for Dr. Tang to perform anesthesia. The reason was that Dr. Tang was familiar with the old man's condition.

There is nothing wrong with this arrangement. It is true that the more you understand the patient's condition, the safer the anesthesia will be.

Since the task has been given to me, I can only do my best.

In order to avoid delayed awakening of the elderly person after surgery, he upgraded the anesthesia plan to combined anesthesia, that is, general anesthesia combined with epidural anesthesia.

By combining the two types of anesthesia, the amount of general anesthetics used can be significantly reduced, and problems such as slow drug metabolism can also be reduced.

The operation, which lasted more than an hour, was over quickly.

When the surgeon started to sew the skin, Dr. Tang stopped giving the general anesthesia. He knew very well that the epidural anesthesia he had given had completely blocked the pain, and the old man would not feel any pain. He did this for only one goal - to wake the old man up in time.

However, even when the surgeon put on the tape, the old man showed no signs of waking up. His heart rate, blood pressure, and expression were all calm.

Dr. Tang, who was a little anxious, tried to call the old man's name. The call even alarmed the people in the operating room next door. The nurses and anesthesiologists in the operating room next door rushed over and asked: What's wrong?

Obviously, they thought something was wrong. That's how it is in the operating room. If something happens, they will rush to help immediately.

When they saw that the patient was not awake, they went back with peace of mind.

As the old man remained unconscious, Dr. Tang became more and more anxious.

Even though I knew the old man had poor hearing, I could only call out loudly.

I looked at the watch and half an hour had passed.

Dr. Tang, who was a little anxious, decided to open the old man's eyes and take a look.

There is a saying that goes, "The eyes are the windows to the soul." This also applies to anesthesia, and it can be said that "the pupil is the sign of anesthesia."

Going back more than a hundred years, at the beginning of modern anesthesia, ether anesthesia used pupils as an important sign for anesthesia stages. This is because anesthetics can affect pupil size. After using anesthetics, the pupil will become smaller. When the anesthesia is particularly deep, the pupil will become close to the eye of a pin. For example: the typical manifestation of morphine poisoning is a pinpoint pupil.

At this time, the eyes are opened to verify whether the anesthetic has been completely metabolized. If the anesthetic has been completely metabolized, the delay in awakening due to the drug factor can be ruled out.

Some people say: If the drugs are completely metabolized, how can the patient not wake up?

This situation does exist, such as brain edema. Brain edema will definitely affect awakening. There are more serious situations, such as cerebral infarction.

The more he thought about it, the more uneasy he became. With an uneasy mood, Dr. Tang silently muttered "I'm sorry" and pulled open the old man's long eyelids.

After opening them, he was relieved - both pupils were normal. In order to verify whether the old man's pupils were normal, he observed the pupils of the circulating nurse.

After making sure that the anesthetic had been completely metabolized, he decided to pinch the old man a little.

Some people say, could it be cerebral edema or cerebral infarction?

Generally not. If there is something wrong with the brain, the pupils will probably show it. What often happens is that the pupils on both sides are different sizes.

After gently pinching the loose skin on his arm, the old man frowned and tried to get up. The crowd was so frightened that they quickly pressed the old man onto the operating table.

After confirming that the old man's breathing was normal and checking the parameters on the monitor, Dr. Tang removed the laryngeal mask inserted into the old man's mouth.

Only then did he remember that he had applied anesthetic to the laryngeal mask to make the old man more comfortable. With the effect of the anesthetic, the old man could certainly tolerate the laryngeal mask.

In retrospect, the combination anesthesia scheme achieved complete analgesia, and the elderly were insensitive to pain and other stimuli, which was the main reason. Poor hearing and inability to open the eyes were secondary factors. But in this special case, the secondary factors also became the main factors.

Here is a question: If you are the anesthesiologist on duty, is there any good way?

[Warm Tips] Follow us, there are a lot of professional medical knowledge here, revealing the secrets of surgical anesthesia for you~