1. What is pre anesthesia risk assessment?
Pre anesthesia risk assessment, abbreviated as anesthesia assessment. It is the comprehensive evaluation of the patient's overall condition by anesthesiologists before anesthesia to determine whether they can tolerate anesthesia. Anesthetic drugs may inhibit the patient's cardiovascular and pulmonary functions while providing comfort, and the occurrence and disappearance of anesthetic effects are closely related to the patient's heart, liver, brain, lungs, kidneys, and other functions. Anesthesiologists will conduct anesthesia risk assessment by reviewing laboratory test results, inquiring about medical history, physical examination, and other methods. The general anesthetics used in modern anesthesia are drugs with minimal impact on the human body and fast metabolism time, which can be completely excreted through human metabolism after surgery. Practice has proven that under the correct use by professionals, general anesthetics will not have any impact on intelligence. After anesthesia, patients may experience brief and mild discomfort such as sore throat, nausea, vomiting, fatigue, dizziness, etc., most of which can completely disappear within a few hours to one or two days.
What preparations should be made before anesthesia?
(1) Whether or not surgery involving the gastrointestinal tract is performed, it is necessary to abstain from drinking and eating before the surgery. When patients receive deep sedation or general anesthesia, their protective coughing and swallowing reflexes may weaken or disappear. The relaxation of the esophageal sphincter makes it easy for gastric contents to reflux into the oropharynx. Once inhaled into the respiratory tract, it can cause respiratory obstruction and aspiration pneumonia, leading to impaired ventilation and difficult treatment, and a high mortality rate in patients. Preoperative fasting and water deprivation are important guarantees for life safety. Regardless of general or partial anesthesia, one must fast and avoid water. Generally speaking, patients of any age can receive clean water 2 hours before surgery, and adults and children can receive easily digestible foods such as milk and semi liquid foods 6 hours before surgery; You can eat normally 8 hours before surgery.
(2) Can I smoke or drink alcohol before surgery?
Long term smoking can increase the incidence of emphysema, lung infections, chronic bronchitis, and lead to an increase in pulmonary secretions. Surgery and anesthesia themselves can make it difficult for lung secretions to be discharged, so smokers have a relatively higher incidence of postoperative pneumonia. Excessive alcohol consumption can damage the liver and affect the metabolism of anesthetic drugs. Overall, smoking and alcohol consumption have adverse effects on the heart, brain, lungs, liver, gastrointestinal tract, endocrine system, and immune system. Therefore, quitting smoking for 8 weeks before surgery has the best effect. If it cannot be achieved, even quitting smoking for 1 day is still beneficial, while quitting drinking for at least 1 week before surgery.
During general anesthesia, long-term alcoholics often require larger doses than the general population, and the specific dosage will be adjusted by anesthesiologists based on professional indicators. However, there will not be patients who cannot be anesthetized, nor will there be situations where there is insufficient or excessive anesthesia.
(3) Suffering from chronic diseases that require medication year-round, does it have any impact on anesthesia?
Generally speaking, commonly used antihypertensive drugs, lipid-lowering drugs, and anti angina drugs can be taken until the day of surgery, and can be swallowed with plain water. However, some drugs require some caution. Blood pressure lowering medication should be discontinued for at least one week before surgery, and other antihypertensive drugs can be switched according to the blood pressure situation. Long term aspirin users should discontinue or use alternative medications as prescribed 2 weeks in advance. For patients who take long-term oral hypoglycemic drugs or use medium and long-acting insulin, it is best to follow the doctor's advice and switch to short acting insulin treatment 1-3 days before surgery. It is also important to avoid taking hypoglycemic drugs or insulin during fasting to prevent hypoglycemia. Some ingredients in traditional Chinese medicine may interact with anesthetics or other medications, posing potential risks to surgical patients. Therefore, all traditional Chinese medicine should be discontinued for at least 24 hours before surgery.
(4) Can't postoperative patients use pillows?
In principle, half body anesthesia patients should lie flat on their pillows for 6 hours after returning to the ward, which is beneficial for reducing headaches. Patients under general anesthesia do not need to lie flat on the pillow. If the type of surgery allows, a semi recumbent position is more conducive to postoperative recovery. Regardless of the type of surgery, as long as conditions permit, early postoperative activities are beneficial.
(5) The incision is very painful after surgery. Will using some painkillers have any adverse effects?
Pain at the surgical site is inevitable, and anesthesiologists will choose appropriate postoperative pain relief methods based on the type of surgery. Postoperative analgesia is beneficial for improving comfort, promoting mobilization, accelerating postoperative recovery, improving sleep quality, and enhancing immune function. However, symptoms such as nausea, vomiting, drowsiness, and skin itching may occur, which can be relieved by symptomatic treatment or reducing the analgesic dose. As time goes by, the incision gradually heals, and the pain will decrease and subside.