Experience sharing on anesthesia.

Pain is the fifth vital signs other than temperature, pulse, blood pressure and breathing. Post-operative pain is the acute pain that follows the surgical damage to the tissue, which not only causes pain to the patient, but also affects the immune and digestive functions of the organism. In clinical practice, anaesthesia is an important part of ensuring the smooth operation and recovery of patients. The following is a summary of detailed clinical experience from pre-aesthesia assessment to the use and maintenance of pain pumps.Pre-aesthetic assessmentPre-aesthesia medical assessment is a key step in ensuring surgical safety and includes, inter alia, the following:(1) Assessment of the medical history: Detailed questions on the general health status of patients, pre-existing diseases (e.g. heart disease, diabetes, hypertension, etc.) to predict and prevent possible problems in the process of anaesthesia.(2) Assessment of the results of the examination: consisting of blood protocol, blood type, coagulation function, liver and kidney function tests, and, if necessary, chest X-rays, electrocardiograms, etc., to assess the CPR function.(3) Assessment of the condition of the operation: Assessment of the nature, complexity and expected duration of the operation, taking into account post-operative pain management and predicting possible complications.(4) Assessment of drug use: Recording of all drugs being used by patients, prevention of interaction with narcotic drugs, adjustment of drug dosages or withdrawals where necessary.(5) Airway assessment: assess the airway structure of the patient, predict the difficulty of inhalation of anaesthesia in the air lane, and consider factors that may affect the respiratory function.2. Treatment of painkillersThe choice of analgesics should be based on the patient ‘ s specific circumstances, type of operation and pain demand. Common painkillers include:(1) Opioid drugs: e.g. fentanyl, morphine etc. are applicable to acute pain management, subject to the side effects of respiratory inhibition, addiction, etc.(2) Anti-inflammatory drugs of a non-prosthetic type: e.g. Brophen, sodium bichlorfonate, etc., apply to mild to moderate pain, with the main side effects being gastrointestinal discomfort.(3) Local anaesthesia, such as Lidocaine, Bubikaine, etc., for local analgesics, with precise and high safety.3. Appliance of pain methodsThe choice of analgesic methods should take into account the pain level of the patient, the extent of the operation and post-operative recovery. Common methods of pain relief include:(1) Intravenous sedation: works quickly, but for short periods, repeated injections are required, and there is a high risk of respiratory inhibition.(2) Injection of muscular pain: slow effect, long duration and low cost.(3) Intraverteal pain: applicable to patients with intravertebrae anaesthesia, which has a precise effect but may cause post-operative urine storage and defecation disorders, etc.(4) Peripheral neurodestructive pain: Injecting anaesthetic into the outer neurological and muscular membranes under super-godic guidance does not affect the patient ‘ s exercise.4. Analgesic impact evaluationThe evaluation of the pain effects is an important component in ensuring the quality of the pain, and common methods of assessment include:(1) Visual Simulation Rating (VSA): allows a patient to mark his or her pain level on a straight line and to be rated by measuring the distance between the mark point and the lowest end.(2) Face expression rating (FPS): Assessing pain by observing a patient ‘ s face.(3) Method of assessment of physiological indicators: Monitoring of physiological indicators such as blood pressure, heart rate, breathing frequency, reflecting the physical state of the patient and the response to pain.5. Monitoring during seditionThe patient should be closely monitored during the pain to ensure its effectiveness and safety. Monitoring will include:(1) Non-traumatological monitoring: blood pressure, electrocardiograms, pulse oxygen saturation, gaseous carbon dioxide etc.(ii) Traumatic monitoring: for large-surgery and high-risk patients, an arterial puncture tube and a central intravenous tube.6. Treatment of side effects of painAnalgesics can cause multiple side effects, such as vomiting, respiratory inhibition and addiction. Principles of treatment include:(1) Discontinuation of medication: Deactivation of painkillers in time for adverse reactions.(2) Catalysing or stomach washing: When overdose is performed, self-motion or co-opting with a doctor.(3) Respiration breathing: The respiratory inhaler immediately takes oxygen and, if necessary, the trachea is cut or intubated.(4) Other: intravenous refilling to prevent hydrolytic disorders, treatment of drug addiction or over-intoxication with antidotes.7. Pain management for special patientsIn the case of special cases (e.g. pregnant women, children, elderly patients, etc.), pain management requires special care. For example, pregnant women frequently suffer from intravertebrate retardation in pain at birth, but attention is to be paid to the risk of pain and fracture in anaesthesia catheters; to the appropriateness of the dose of the drug and of the pain method when a child is in pain; and to the effects of analgesics on the liver and kidney function.8. Use and maintenance of pain pumpsAnalgesic pumps are common equipment for post-operative pain relief, which relieves pain through continuous or intermittent infusion of painkillers. Elements of use and maintenance include:(1) Selection of appropriate pain pumps: Selection based on the patient ‘ s condition and pain needs.(2) Correctly set parameters: e.g., speed of loss, time of loss.(3) Periodic monitoring: observation of the state of work of the pain pump and of the pain effects of the patient.(4) Timely handling of malfunctions: e.g. pain pump alarms, low drops, etc. require timely screening and disposal.In conclusion, clinical experience of anaesthesia pain covers many aspects, from pre-aesthetic assessment to the use and maintenance of analgesic pumps. Scientific and sound pain management ensures the smooth operation and rapid recovery of patients.