Local anaesthesia: potential threat to surgical safety
In the field of medical surgery, local anesthesia is a common anaesthesia that allows patients to successfully complete the operation by not feeling pain in a particular area of the body. However, the complication of local anaesthesia can occur inadvertently, posing a serious threat to the health and safety of patients.
I. Concept of local anaesthesia
Local anaesthesia is used to temporarily disrupt neurotransmission in a certain part of the body through local anesthesia, for pain relief purposes. However, local anesthesia may occur when the authorities enter the blood cycle too quickly and at high concentrations. This is a serious anaesthesia and can lead to functional impairments in multiple systems such as the patient ‘ s nervous system and cardiovascular system.
II. Common causes of local anesthesia
1. Overdose
This is one of the most important causes of local anesthesia. It may be that an anaesthetist errors in the calculation of a drug dose, or that, due to individual differences in the patient (e.g., underweight, special physical condition, etc.), an otherwise appropriate dose becomes an overdose in the particular patient. In addition, for some complex operations, local anaesthesia requires a large area or a long period of time, and an overdose is also prone to overdoses if the dose is not accurately calculated and adjusted.
2. Misinfusion of blood vessels
When local anaesthesia is administered, even a normal dose of local anaesthesia can rapidly and significantly enter the blood cycle and cause poisoning if the needle is accidentally inserted into the vein. This is more likely to occur in areas where it is more difficult to operate (e.g., in areas where the neck and armpits are rich) or inexperienced doctors.
3. Local anaesthesia is too fast to absorb
The absorption rate of local anesthesia is affected by a number of factors. For example, local anesthesia can be absorbed more quickly in blood-rich areas (e.g., scalp, mucous membranes, etc.). In addition, factors such as the use of angiogenesis or the patient ‘ s own high-heat state can accelerate the absorption of local anesthesia and increase the risk of poisoning.
III. Clinical manifestations of local anesthesia
1. Symptoms of the nervous system
The early stages are usually characterized by excitement, and patients may experience abnormal feelings of dizziness, ringing ears, blurred vision and numbness. As the level of poisoning increases, there are serious symptoms of muscle convulsions and convulsions. When convulsions occur, the whole body muscle of the patient is severely constricted, which can lead to respiratory convulsions, leading to suffocation and a serious threat to life. If further intoxication occurs, central nervous system inhibition may occur, in the form of sleep addiction, coma, etc.
Symptoms of the cardiovascular system
The heart rate of the patient may be abnormal, it may accelerate at an early stage due to excitement and can subsequently slow down due to myocardial inhibition. At the same time, blood pressure fluctuates and is likely to rise at an early stage, followed by a decrease in blood pressure as myocardial contraction and blood vessels expand. Severe hypotensive pressure can lead to insufficient infusion of vital organs, such as the heart, the brain, and cause damage to the functioning of organs. In addition, there may be heart disorders, such as indoor early paces, room tremors, etc., which are very dangerous and can lead to cardiac arrest.
3. Respiratory symptoms
Respiration frequency and depth may change, and it may accelerate at an early stage, and respiratory inhibition may increase as the disease progresses, in the form of shallow and slow breathing. In the event of convulsive attacks, respiratory convulsions can further exacerbate respiratory disorders, leading to low oxygen haematosis and carbon dioxide retention, causing serious damage to the organism.
IV. Diagnosis of local anesthesia
The diagnosis of local anaesthesia is mainly based on the patient ‘ s clinical performance, history of use and anaesthesia. If the above-mentioned symptoms of the nervous, cardiovascular and respiratory systems occur within a short period of time after the local anaesthesia, and other possible causes are excluded (e.g., the original disease of the patient), local anaesthesia should be highly suspected. The detection of local anaesthesia levels in blood can be used as an aid for diagnostic purposes, but in actual clinical practice, testing takes some time and is often not used in a timely manner to guide first aid.
V. Treatment of local anaesthesia
1. Immediate cessation of delivery
If local anaesthesia is suspected, the injection of local anaesthesia should be stopped immediately to prevent further intoxication.
2. Protection of the patient ‘ s respiratory tract
The patient ‘ s head is tilted to the side to prevent the vomit from being missorted. If the patient suffers from respiratory inhibition or convulsion, measures such as tube intubation or ventilation should be implemented in a timely manner to ensure that the patient has adequate oxygen supply. Respirator-assisted breathing is used when necessary.
Control of convulsion
In cases of convulsive convulsions, i.e. sedation drugs, such as IVT, can be used to relieve muscle convulsions and to protect patients from further harm caused by convulsions, such as fractures, asphyxia, etc.
4. Maintenance of circular stability
Cardiovascular indicators such as heart rate and blood pressure are closely monitored. If low blood pressure occurs, the blood capacity of a quick infusion crystal or adhesive rehydration can be increased using vascular active drugs (e.g. ephedrine, dopamine, etc.) if necessary. Cardiopathic disorders are treated according to specific types.
5. Promoting local anaesthesia
Local anaesthesia can be accelerated from the body, for example, by infusion, while care is taken to maintain the hydrolytic balance of the patient.
Prevention of local anaesthesia
1. Accurate calculation of the drug dose
Anesthetists should calculate the dose of local anesthesia accurately before the surgery, depending on the patient ‘ s weight, age and state of health. For special patients (e.g. children, the elderly, pregnant women, etc.), the dose is more carefully adjusted.
2. Normative operations
Injection of local anesthesia is carried out in strict compliance with the protocol and as far as possible is done in order to avoid misinfusion of the blood vessels. Injection can be preceded by a retort to see if there is a reflow of blood, especially when operating in vascularly rich areas.
3. Patient care
Anaesthesia programmes have to be adjusted for patients with cardiovascular diseases and incomplete liver and kidneys, to understand their physical condition and medical history. At the same time, attention should be paid to such factors as the temperature of the patient and local blood transport, so as to avoid poisoning due to the rapid absorption of local anesthesia.
Finally, local anaesthesia is a matter of high vigilance during the local anaesthesia process. Only if medical personnel such as anaesthetists, surgeons and nurses are fully informed of their causes, manifestations, diagnosis, treatment and prevention methods can their likelihood of occurrence be minimized and the safety of patients under local anesthesia be guaranteed. At the same time, patients and their families should be aware of this potential risk and actively cooperate with the health-care staff to ensure the smooth operation.
Anaesthesia.
