Is it difficult to walk away from general anesthesia? Nursing care during recovery from anesthesia and in the near future after surgery

When organizing the care of patients with a surgical profile, it must be borne in mind that any surgical intervention is accompanied by the development of stress in them, and most operations are performed under general anesthesia. Both circumstances require close attention to the patient in the next few hours after the operation.

With complete recovery of consciousness, stabilization of breathing and hemodynamics, the patient can be transferred to a specialized department. In the same case, when there is the slightest doubt or the likelihood of a complication, the patient is transferred to the postoperative (post-anesthetic) ward, which should be directly adjacent to the operating unit. If there is no such ward, then the patient is transported to the intensive care unit.

The patient is transported on a gurney accompanied by an anesthesiologist who performed anesthesia. During transportation, cardiac arrest and respiratory arrest may occur, in which resuscitation measures are immediately carried out.

In the patient's ward, they are placed on their side, thereby, in case of vomiting, they prevent the ingress of vomit, saliva or mucus into airways... After the restoration of protective reflexes and consciousness, the patient is given the desired position. The patient, who is in a state of excitement, is fixed with soft straps. Then the monitoring equipment is connected. Patient monitoring is organized by the anesthesiologist-resuscitator and conducted by the nurse-anesthetist.

The main tasks of sick shortly after the operation are:

 prevention of respiratory failure;

 prevention of circulatory disorders and homeostasis;

Relief of pain syndrome;

 prevention of infectious complications.

IN postoperative period can be observed respiratory depressiondue to the continued action of substances that were used during anesthesia (anesthetics, narcotic analgesics, muscle relaxants). Weak diaphragmatic breathing and paradoxical movements of the chest (during inhalation, it rib cage are indications for artificial ventilation.

Recovery of synchronous respiratory movements chest and abdomen (diaphragmatic breathing), as well as sufficient muscle strength, when the patient can shake hands, raise his head and hold it in this position for at least 2 seconds indicates the cessation of the effect of medicinal substances.

During the period when the patient comes out of anesthesia, oxygen starvation (hypoxia) may occur, the most important feature which is cyanosis (bluish tint) of the skin, but its absence does not exclude hypoxia. The main cause of hypoxia is a violation of free airway patency. Vomiting and regurgitation of gastric contents are especially dangerous. Vomiting occurs due to the action of anesthetics and narcotic analgesics, as well as as a result of hypoxia during anesthesia and in cases where the stomach is full. When the patient lies horizontally or with the head end down, regurgitation (fluid flow in the opposite direction to physiological) gastric contents, i.e. its passive flow into oral cavity.

When vomit enters the respiratory tract, i.e. at their aspiration, occlusion of the bronchial tree may occur. In patients, mechanical asphyxia occurs, which ends with respiratory arrest and death. This complication is prevented by emptying the stomach using a probe before the operation, and at the end of the intervention, the contents are removed from the stomach again. Laying the patient after the operation in position on the side, prevent aspiration of gastric contents, and tongue sinking, which can also lead to asphyxiation. This situation does not completely exclude the occurrence of these complications and is standard when transporting unconscious patients. As an exception, it is applicable when, when removing the patient from anesthesia, the protective reflexes are insufficiently restored. In order to prevent the tongue from sinking, they use an air duct or resort to the so-called triple Safar technique (tilting the head back, pushing the lower jaw forward and opening the mouth).

In the event of this complication, the head end of the patient's body is lowered down. Then the mouth is cleaned with a napkin or suction. The trachea is freed from vomit by pressure from the sides on the chest. The patient is intubated and the bronchial tree is washed in small portions with a solution of baking soda with suction of the liquid, or sanitation bronchoscopy is performed.

Increased pain in the area of \u200b\u200bthe operation limits the depth of breathing and prevents the expectoration of sputum. Insufficient ventilation of the lungs, including when the bronchioles are blocked with mucus, leads to the formation atelectasiswhen a part of the lung loses its airiness, it collapses and inflammation develops here. To prevent this, it is necessary rational pain relief... Important breathing exercises, every hour the patient should take 5 deep breaths and exhalations, also independently or with the help of staff change in body position, early active movements up to getting up and massage the chest. When sputum is released, every 3-4 hours for a few minutes, the patient is given postural position (on one side or another, on the back), in which mucus moves well into the large bronchi and is relatively easy to cough up. With a large amount of sputum, direct laryngoscopy is performed, a thin catheter is inserted through the glottis and mucus is actively aspirated.

Circulatory disorders in the postoperative period is often associated with hypovolemia (decrease in fluid in the body), which exists before or during and after surgery. In order to prevent these disorders, the missing fluid is replenished by transfusing electrolyte solutions and plasma substitutes. To determine the required volume of infusions, an accurate record of the secreted fluid with urine, feces, vomit, through drains, fistulas, gastric and intestinal tube is carried out.

For infusion therapy perform venipuncture or venesection. The most optimal catheterization of the main vein. The catheter can be a conductor of infection, and, caring for it, they promptly change the contaminated material with which it is fixed to the skin. In case of phlebitis, the infusion into this vein is stopped and the catheter is removed. The venous catheter becomes thrombosed, blood clots form around it. The separation of a blood clot leads to thromboembolic complications, in order to avoid which the catheter is regularly, 2-3 times a day, washed with saline with heparin.

With dehydration, negative central venous pressure is observed, its suction effect contributes to the entry of air through the dropper into the vascular bed and the occurrence of air embolism... For its prevention during infusions, the absence of air bubbles in the system and its tightness at the junction with the catheter are monitored. After the end of the infusion, the catheter cannula is closed with a special stopper.

After general anesthesia absolutely everyone feels bad, although no ethers are used now.

It is well known that after their use, the liver stopped working in many patients.

Is general anesthesia harmful or is it a myth? Does anesthesia affect life expectancy, human health?

Modern drugs for anesthesia are slightly toxic to human organs.

If the dose for you is calculated correctly, the drug was administered correctly, there is nothing to be afraid of.

But we are afraid of anesthesia, pain, although we understand the inevitability of the operation and its necessity.

Now there are a lot of new things: equipment, drugs, a lot of new technologies, but we are still afraid, maybe we don't know what anesthesia is? What to expect from him?

Anesthesia implies safety during and after surgery.

The patient's condition after general anesthesia, of high quality in a good clinic:

After the operation, the patient is anesthetized, if this is not enough, the patients themselves make an injection by pressing a button.

For this, special devices have appeared, which the patient constantly carries with him.

Doctors then monitor how many times the patient has pressed the button, according to these calculations, they determine the degree of recovery of the patient.

Thanks to this, the time after the operation is comfortable.

Before taking general anesthesia, take into account:

• Your weight or body mass index.
• The medical history, analyzes, permissions from specialists for anesthesia are being studied.
• The patient's age.
• Your current medications and allergic reactions on them.
• The consumption of alcohol or drugs by patients.
• Dental examination, as well as the oral cavity, respiratory tract.

General anesthesia, what is it:

General anesthesia, a state of coma, sleep in which the patient does not feel pain. He is not in pain, there are no reactions. The person seems to be unconscious.

General anesthesia is given intravenously or inhaled.

Medicines are administered by an anesthesiologist, a specialist who monitors the patient's vital signs, breathing during surgery.

There are four stages:

Induction or first stage:

It is characterized by the onset of drug administration and loss of sensitivity (consciousness).

Arousal stage - second stage:

Delusional, excited activity arises. Heartbeats and breathing are irregular.

Nausea and dilated pupils may occur.

There is a danger of suffocation. Modern drugs limit the time to the two stages described above.

Surgical anesthesia or stage three:

When it occurs, all muscles relax, breathing is suppressed. Eye movement slows down, then stops. The patient is ready for surgery.

Overdose stage, if the dose of anesthesia was incorrectly calculated for you:

Leads to respiratory failure.

As you can imagine, the fourth stage is an exception to the rule, but it sometimes happens, as everywhere and always.

Why is it just general anesthesia, and not anesthesia of only the necessary part of the body?

Under what circumstances is he appointed?

• The operation takes a long time.
• Risk of severe blood loss.
• According to the indications of the patient's well-being.

Modern surgery is an absolutely safe intervention.

Immediately after anesthesia, you may feel:

• Difficulty passing urine.
• Bruising, soreness on the arm due to the dropper during the operation.
• Constant nausea, vomiting is possible.
• Shivering and feeling cold, you will be shaken, getting warm at first is problematic.
• Sore throat (due to the presence of a breathing tube during surgery).
• You will not feel pain, nurses will constantly provide pain relief.

But there are more serious risk groups for the consequences:

Elderly people with long-term operations are at risk of serious consequences.

After anesthesia, they can get a heart attack, amnesia (memory loss), stroke, and even pneumonia.

Of course, it is good that now you can do the operation, recover, if not for the consequences after it. They are.

The consequences are early and appear later.

The early consequences are visible immediately, the person does not come out of the state of anesthesia, a cerebral coma sets in.

The consequences appear after a few days or weeks:

• Strong headache, which is difficult to remove with analgesics. They often have to be removed with drugs.
• Sleep apnea - people stop breathing for a short period of time during sleep.
• Blood pressure rises.
• , can last up to a day.
• Arise panic attacks, fear that interferes with normal life. A person does not understand where it comes from, what to do.
• Leg cramps, calves, bringing incredible suffering to the patient due to the frequent occurrence.
• The heart suffers, there are malfunctions in her work, the pulse is frequent with.
• Kidneys and liver - the organs of purification of our body - suffer. Whatever the drugs for anesthesia, but so that a person does not feel anything, an incredibly huge dose of them is needed. Naturally, healthy organs are needed to cleanse everything.
• Sometimes alcoholism develops.
• body.

Help yourself after surgery :

It is very good to drink the courses:

• Piracetam, Cavinton (improves blood circulation and brain nutrition). Memory will recover faster, headaches will disappear.
• Take another ECG (electrocardiogram), see what happened to your heart after the operation.
• Donate blood, go with the received tests to a therapist. Don't waste time.
• Avoid anesthesia anytime, anywhere. Treat your teeth under local anesthesia.

Sometimes life and health force us to go to extreme measures in methods of recovery - to do an operation, to endure anesthesia and crawl out after general anesthesia, to get rid of the consequences after general anesthesia.

This life can be anything in it. Fewer such episodes in your life. Health and longevity!

I am always waiting for you on my site.

Watch the video, allergies and anesthesia:

Getting out of anesthesia after surgery worries many people more than the course of surgery itself. Indeed, during it, a person does not feel anything, but after the withdrawal of anesthesia, unpleasant sensations arise. And they are associated not only with the return of sensitivity in the area of \u200b\u200boperation: in addition to pain, the patient sometimes experiences a lot of excruciating symptoms that can last for several hours.

Features of local anesthesia

Local anesthesia is understood as temporary anesthesia of a small area of \u200b\u200bthe body due to exposure to external drugs or injecting with a medicinal solution. In the definition, one can immediately see a large classification of types of local anesthesia: superficial and internal. The latter, in turn, is divided into several more subtypes, depending on the area of \u200b\u200bexposure (epidural, conduction, spinal, infiltration).

Local anesthesia is used in almost all areas of medicine, but dentistry is the most prominent example. Today, almost all manipulations are performed with anesthesia. And if earlier the patient had to endure for 10-20 minutes while the doctor drills the tooth, cleans the canals, puts the filling, now all painful sensations are reduced to a second tingling sensation from the introduction of a thin needle.

How is

All types of local anesthesia have their own characteristics, but on average it is something like this: a person is injected with a medicine in a specific area. After a few minutes, sensitivity in this area is lost, and doctors can start manipulating. At the same time, the patient is conscious, but he does not feel anything, not even the touch of a cold instrument. General state is also stable, although some admit to experiencing mild nausea and dizziness. But doctors associate this more with excitement than with pain relief.

By the way! Sometimes, before the needle is inserted, the skin is pre-anesthetized with external anesthetics in order to reduce pain from the puncture of soft tissues. It turns out a combined local anesthesia. It is used, for example, for epidural anesthesia.

How does anesthesia go

The amount of injected anesthetic and the choice of its type is calculated based on the complexity of the operation and the patient's physique. But the medicine is always taken with a margin, so that the anesthesia does not suddenly come off accidentally during medical procedures, if they take more time. Accordingly, after the end of the operation, the patient has a few more minutes (sometimes even a little more than an hour) for the anesthetic to stop working.

Sensitivity returns gradually, but quickly enough. At first, a person begins to feel touches, and after a minute or two he feels pain in the place of manipulation. If it was a dental procedure, then the puncture zone of the gums or the hole after the extracted tooth may ache.

In the treatment of caries, as a rule, pain after the withdrawal of anesthesia is not felt. If it was a more complex operation, for example, to remove an ingrown nail, then the operated finger may start to hurt quite badly, because there was a violation of the integrity of the tissues. But these pains can be relieved with analgesics.

Possible complications

Some people are allergic to certain types of drugs. Local anesthesia involves the use of Lidocaine, Novocaine, Bupivacaine, etc. And a person may react to them in the form of:

These reactions appear immediately after drug administration. And if the first two are quite tolerable, then the last three require termination of the operation and hospitalization of the patient. You can find out about the availability by preliminary conducting an allergy test.

Some people note certain reactions after the withdrawal of local anesthesia: dizzy or a headache, weakness appears, tends to sleep, the temperature rises. But it is impossible to say for sure whether this is an allergy to the medicine or the consequences after the operation.

Features of general anesthesia

A more complex type of anesthesia, which involves immersing the patient in a narcotic sleep and completely depriving him of not only sensitivity, but also consciousness. It is difficult for people who have never been exposed to this in their lives to imagine such a state. Therefore, many are afraid of their first operation under general anesthesia.

General anesthesia is also successfully used today in all areas of medicine. Moreover, sometimes this is the only chance to perform an operation. In dentistry, this type of pain relief is also used when a person (usually a child) is unable to overcome their fear of going to the dentist.

There are two main types of general anesthesia: inhalation (through a mask) and. Combined anesthesia is sometimes used. What it will be in a particular case, the doctor decides, depending on the specifics of the operation and the patient's physiology.

What is made up of

General anesthesia consists of three "components": analgesia and muscle relaxation. In fact, a person simply falls asleep, but in fact, completely different changes take place in his body. During normal sleep, breathing is calm, the body is relaxed, but reflexes are preserved.

And if you poke a person with a pin or just pat him, he will wake up. And narcotic sleep also implies analgesia - the suppression of the body's autonomic reactions to all types of interventions: punctures, incisions, manipulations with internal organs etc.

The third "component" of general anesthesia - muscle relaxation - is necessary to facilitate the work of surgeons during the operation. Due to the presence in medicinal solution muscle relaxants, the patient's muscles are relaxed as much as possible and also cannot reflexively respond to interventions (contract, strain).

How is

If this is a general anesthesia of the inhalation type, then a mask is put on the patient's nose and mouth through which a gas-narcotic mixture is supplied. A person is required to breathe evenly and not resist the onset of sleep. Using the sensors connected to the body, the anesthesiologist determines when the anesthesia has fully worked, and signals this to the surgeons.

Implies an introduction medicines through the skin. Such anesthesia is considered deeper and more reliable, while inhalation anesthesia is used for simple operations. If a difficult and long-term intervention is to be done, then combined anesthesia is used: first, then a mask is added.

By the way! During the action of general anesthesia, doctors must observe the main indicators of the body's viability, thanks to the equipment and external signs. The color of the patient's skin, body temperature, heart rate, pulse - all this allows you to control the course of anesthesia and a person's condition.

How much do they leave from general anesthesia

People sometimes fear for their well-being at the time of recovery from general anesthesia after surgery, because this difficult process... Although, it is difficult for the anesthesiologist, but rather unpleasant for the patient. It is like waking up from a very heavy sleep. In this case, the following sensations may be noted:

If the general anesthesia was light, then the patient after the operation goes to the ward and "wakes up" himself. After deep anesthesia, the person is necessarily "woken up" by the anesthesiologist. This can happen right in the operating room, or in the intensive care unit after some time.

By the way! Some people come out of general anesthesia for hours and experience all of the above symptoms.

Possible consequences

General anesthesia is stress for the body, which during its action actually balances on the brink of life and death. Yes, everything happens under the control of a medical team, but still breathing almost stops, there are no reflexes, the heart beats very weakly. Therefore, the consequences associated with disruption of the normal functioning of the cardiovascular and respiratory systems are not uncommon. This is manifested by a decrease or increase in pressure, spasms of the larynx and bronchi, sputum production, and hiccups.

Is it possible to ease the exit from anesthesia

You can reduce the intensity of unpleasant sensations if you properly prepare for the operation. To do this, you need to frankly tell the doctor about your past illnesses and your concerns, follow a diet, and conscientiously take the prescribed medications. If the patient arbitrarily refers to preoperative preparation, eats secretly from the doctors, runs to smoke or drinks some pills, then this will create problems during the surgical intervention. Moreover, they will be associated not only with immersion in and out of anesthesia, but also with the course of the operation itself.

It is necessary to follow medical recommendations even after general anesthesia has ceased to work. If the doctor allows you to get up and walk, you need to do this to prevent thromboembolism (blockage of the veins). Some people are advised to just move their legs for the same reason. It is not recommended to grab a book or a smartphone right after waking up: it is better to rest and think about something good, for example, that everything is over. And in no case should you neglect the doctor's instructions, which, depending on the type of anesthesia and the operation performed, may be different.

The question of how much they leave from general anesthesia after the operation worries people who will surgical intervention... Probably, many are not so afraid of the operation itself as side effects from anesthesia.

Properly conducted anesthesia will help you get out of this state quickly and with minimal harm to health.

Anesthesia: pros and cons

Anesthesia is a condition caused by an artificial (medication) way nervous system, in which it is inhibited and does not respond to pain. In this case, there is a complete relaxation of the muscles, the loss of some reflexes, the body plunges into deep sleep.

This condition is achieved by the introduction of special anesthetic drugs, which provide such an effect. The dose of the drug carefully calculated by the anesthesiologist will help the body to recover from anesthesia faster. Conversely, the slightest mistake in these calculations can lead to tragic consequences.

Anesthesia is designed to protect the human body from surgical trauma. It's not just taking off pain, but also the protection of the body. Despite the fact that anesthesia is designed to help a person undergo surgery, it is often he who becomes the cause of complications and side effects. Although modern medicine moved away from the use of highly toxic drugs that were used in the past, sometimes such phenomena are present.

As a rule, before the operation, the anesthesiologist is obliged to tell the patient about how pain relief works, about all its risks and side effects... The presence of comorbidities and allergies plays an important role. That is why you need to undergo a very thorough examination before the operation.

Back to zmistVidi and types of anesthesia

Anesthesia is divided into the following types:

• general;
• regional;
• local.

General anesthesia is the most difficult type of anesthesia. This is the only type of anesthesia when the patient is completely unconscious. At its core, this is a very deep sleep caused by special medicines... This type of pain relief is used for serious and long-term operations.

This type of pain relief requires an airway. If the surgery is to be prolonged, then aspiration may occur - a condition when the contents of the stomach enter the respiratory tract. In this type of anesthesia, a special tube is inserted into the patient to provide breathing. Or a special mask is used, which is called a laryngeal mask. These devices are installed in the respiratory tract when the person is already asleep, so they do not cause discomfort.

Anesthesia happens:

• venous (drugs are injected into a vein);
• endotracheal (through a special tube);
• mask (the patient breathes through the mask).

There may also be a combination of these methods. The depth of anesthesia (how deeply the patient sleeps) is controlled by the doctor by changing the dose of the drug. With prolonged and serious interventions, sleep is deeper. At the end of the operation, the doctor stops the medication, thus preparing the patient to come out of sleep.

Return to the zmist, the hour in which they get out of anesthesia

Throughout the operation, the anesthesiologist monitors the concentration of drugs in the patient's blood, controls the heartbeat, body temperature, breathing using special devices. After the operation, the patient begins to recover from anesthesia. Muscle sensitivity, reflexes return, a person comes to his senses. The anesthesiologist usually asks the patient to answer a few simple questions. So he makes sure that the patient has returned to consciousness and can normally recover from the anesthesia.

The body needs some time to remove medicationsused for general pain relief. During this time, doctors will monitor the patient's organs and systems to make sure they are functioning normally. In some cases, in order to quickly withdraw from anesthesia, special medications are used that neutralize narcotic substances.

As a rule, with a correctly calculated dose of anesthetic and a normal reaction of the body, the recovery time from general anesthesia lasts about 4 hours after the end of the surgery. After leaving, the patient is usually injected with pain relievers, and he will be half asleep for about 12-18 hours. This is absolutely normal phenomenon, which should not bother loved ones.

For some time after coming out of this state, the patient experiences some unpleasant phenomena.

The exact time during which drugs for pain relief will be removed from the body depends on the individual characteristics of the body, age, and state of health.