The puncture needle goes through five layers. It is not easy to get this pain-relieving injection when giving birth!

Isn’t anesthesia just an injection?

I think most people think so, right?

As China Anesthesia Week approaches again, as an anesthesiologist, I feel deeply moved: despite years of advocacy, the status of anesthesia has not improved at all. Apart from a few important leaders speaking out, there seems to be nothing new.

What I want to say is: We don’t need leaders to be passionate! What we need is for policies to be truly implemented and for status to be truly improved!

Some people say: Isn’t your status as a doctor high enough?

Sorry, the "doctor" you are referring to does not include us anesthesiologists. It is not that we do not recognize ourselves! Rather, the hospital leaders and surgeons have not paid enough attention to the anesthesiology department!

Specifically, when talking about salary and benefits, the Anesthesiology Department is an auxiliary department; when the Anesthesiology Department is needed to treat critically ill patients, it becomes a clinical department.

Although the Anesthesiology Department does its best to ensure the success of critically ill patients during operations, flowers and applause have never been associated with the Anesthesiology Department.

At this point, many friends may ask: What does this mean?

Let's take an example: a surgery for a ruptured liver and massive bleeding due to a car accident. What the anesthesiology department has to do is to ensure the depth of anesthesia while providing good abdominal muscle relaxation conditions for the surgery department. More importantly, it has to ensure that the patient is alive.

Staying alive may seem simple. In fact, anesthesiologists have to fight shock all the time. They not only use various vasoactive drugs, but also blood transfusion and fluid replacement. If there is any mistake, the patient's vital signs will plummet.

In some of these heavy bleeding surgeries, blood pressure must be deliberately lowered to facilitate surgical hemostasis. This can also help preserve the little bit of vital blood left in the patient's body. But this process is not easy. Looking at the blood pressure on the alert line, the anesthesiologist's blood pressure is high from beginning to end.

If you find it difficult to understand these contents, let’s talk about this “injection thing”.

In the past, giving birth was all about luck! If you were lucky, both mother and child would be safe; if not... Therefore, the ancients likened giving birth to "a trip through the gates of hell."

This statement cannot be taken too far. In the last century, when many people gave birth to children at home, giving birth was also a dangerous thing!

Nowadays, childbirth is much safer and less painful, thanks in large part to cesarean sections and labor analgesia.

Cesarean section can save the lives of those who are having difficulty delivering a giant baby, have cephalopelvic disproportion, or have a weak fetal heart rate.

If you want to perform a cesarean section or labor analgesia quickly and safely, you cannot do without a technology from the Department of Anesthesiology - spinal puncture.

If you are unfamiliar with this term, are you familiar with the term "half anesthesia"? Yes, this anesthesia is what people often call "half anesthesia".

How is this anesthesia performed?

The first step is to let the patient lie on his side on the operating table. And he cannot move during the whole process.

The second step is a series of operations including positioning, disinfection, and laying of towels.

The third step is puncture.

Puncture process: First, a local anesthetic is given. After the local anesthetic is given, it will not hurt so much. After that, a hollow puncture needle as thick as a matchstick is used to pierce the skin, subcutaneous tissue, supraspinous ligament, interspinous ligament and yellow ligament in sequence.

During this period, the anesthesiologist is required to use his experience to accurately judge which layer the puncture needle has reached. If the judgment is wrong, it will not only lead to poor anesthesia: at the least, cerebrospinal fluid leakage and possible complications such as postoperative headaches; at the worst, nerve damage!

Think about it: how much pressure the anesthesiologist is under during the puncture process!

Of course, we must put ourselves in their shoes at this time: patients are generally very nervous, because most people may not be able to stand someone operating on their backs. In particular, the more they understand the risks of this operation, the more worried they may become.

However, don’t worry, the anesthesiologist is here!

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