The legs can still move after anesthesia. Is it a white-hearted deception or a medical malpractice?

I want to share this article because of a minor incident during surgery a few days ago. Although this incident may seem like a small matter in our daily diagnosis and treatment, it may really be a big deal for patients. Therefore, it is necessary for us to let everyone know and understand.

On that day, this was a popliteal cyst removal operation. The anesthesia method chosen was epidural anesthesia.

The reason for choosing epidural anesthesia was also studied in detail before the operation: on the one hand, epidural anesthesia is a very mature anesthesia method that plays an important role in the history of anesthesia. It can be said that in the past when general anesthesia technology was immature, epidural anesthesia almost single-handedly carried the entire modern surgery. On the other hand, epidural anesthesia has advantages that general anesthesia still cannot replace. For example, it has a definite surgical analgesic effect and excellent postoperative analgesia treatment.

More importantly, anesthesiologists have found in clinical practice that by controlling the concentration or dosage of the drug, they can even accurately control the degree of sensory blockade and motor blockade. In particular, after the advent of new local anesthetics, this "motor-sensory separation" anesthetic effect has even become an advantage in certain surgeries.

Take this patient's surgery for example. She had had popliteal cysts for several times. Repeated surgery has left her with severe scars in the popliteal area. Severe scars mean that the anatomical boundaries during surgery may be very unclear. Without clear anatomical boundaries, not only can the surgical effect not be guaranteed, but side effects may even occur. For example, some important tendons may be cut off.

For this reason, when choosing the anesthesia method before the operation, the Department of Anesthesiology made an exception and provided this rare anesthesia plan for the surgery department. However, because the content was too professional for the patient, she could only be briefly introduced to the anesthesia method, which was epidural anesthesia in spinal anesthesia, and the effect was that the lower body was in an anesthetized state.

During the preoperative anesthesia, she, who had had many surgical experiences, could feel the effect of the anesthesia coming: after the anesthesiologist injected the anesthesia, he would quickly ask her to turn over and lie flat. After that, the anesthetic moved upward little by little. In the end, her belly was numb. She even didn't know where her legs were. Not to mention the movement of lifting her legs, that was impossible.

However, when she quietly lifted her legs to feel the effect of the anesthesia, she was surprised to find that her legs could be lifted all the way up. At this time, the doctor had already started to disinfect and spread the drape.

At that moment, she was extremely nervous: Would the doctor operate without waiting for the anesthesia to take effect?

Then I thought: Fortunately, I am conscious. If the doctor hurts me, I will scream. There are so many people in the operating room, it won't be a hard cut, right?

Soon, she heard the message "operation started" from the conversation between the surgeon and the anesthesiologist. Uncontrollably, her heart rate soared. She felt as if her heart was about to jump out of her chest. She couldn't believe that the doctor would operate under such circumstances.

Although she tried hard to restrain herself, she finally shouted: Doctor, wait a minute, I think the anesthesia is not working, please take a look.

As she said this, she really lifted her legs up.

Seeing this, the nurse immediately held her legs and said: "Don't move! It's too dangerous if you move like this!"

At that moment, she couldn't bear it any longer and said, "The anesthesia hasn't taken effect yet! It's me who's in pain! If you do this, I will file a complaint against you and sue you!"

Seeing that she was very excited, my anesthesia colleague immediately comforted her and said: This is how anesthesia works. You may feel everything and even move, but it will not hurt, so don't worry.

She asked in confusion: "Then tell me, why can my legs still move?" My colleague explained that after we precisely controlled the concentration of the drug, we could only eliminate the pain. As for the legs still being able to move, we did it on purpose. The purpose was that if we couldn't determine which one was the tendon during the operation, we would let you know by moving it.

After hearing this explanation, she remained silent, half believing and half doubting.

Then, the operation officially began. It was precisely because the Department of Anesthesiology precisely controlled the drug concentration and used a new type of local anesthetic that the anesthesia was successful.

The operation was as expected and the surgery was a complete success. This time, the surgery was very thorough and there was no side effect.