医生趣闻:全麻是一种怎样的体验?

2016-07-23 麻骑士 知乎

我没得什么病,或者得了精神病,我今年年初(一月份)写年终总结,统计去年我的手术量,做了九百多台手术的麻醉,而我却未曾体验过整个全麻过程是怎样的感觉……顿时,一颗好奇的心骚动起来,我提出由我的同事为我做一次全麻,并按照我的用药习惯制定详细的步骤。本人男 29岁 身高175cm 体重70kg 烟史5年(请不要在意这些细节,勿喷),无酒史(偶尔啤酒),无手术史、过敏史,无高血压糖尿病等其他基础疾病。下面

我没得什么病,或者得了精神病,我今年年初(一月份)写年终总结,统计去年我的手术量,做了九百多台手术的麻醉,而我却未曾体验过整个全麻过程是怎样的感觉……


顿时,一颗好奇的心骚动起来,我提出由我的同事为我做一次全麻,并按照我的用药习惯制定详细的步骤。


本人男 29岁 身高175cm 体重70kg 烟史5年(请不要在意这些细节,勿喷),无酒史(偶尔啤酒),无手术史、过敏史,无高血压糖尿病等其他基础疾病。



下面我详细写出每个步骤,及切身体会:

1、术前药:右美托咪定30ug,昂丹司琼4mg,地塞米松5mg(置于500ml生理盐水静脉滴注)~没啥感觉。

2、全麻诱导药:
①依托咪酯10mg缓慢静推~有点困了,但我努力地保持清醒,并试图通过说话证明自己还清醒。
②顺式阿曲库铵10mg快速静推~眼皮抬不起来了,卧槽,我要被放翻了!
③舒芬太尼20ug快速静推~有一丝天旋地转的感觉,后面不知道了…

3、气管插管:选用ID7.5普通气管导管,达克罗宁涂抹后麦氏喉镜插管~我同事说,为了让我有更深刻地体验,他在脉氧只有70时才给我插管,简直禽兽不如。然而我并没有啥感觉。

4、麻醉维持:丙泊酚200mg/h维持至肌松时间结束~万恶的同事为了满足自己的好奇心,开了0.5MAC的七氟烷,开了半小时。然而我全然不知。

5、麻醉复苏:
①唤醒:我被拍了两下脸,有点醒了,但还是很想睡觉,非常非常困,管子卡在喉头很难受,但仍在我的耐受范围。我完全不知道过了多久,很想知道现在几点了。同事在身边,让我用力握紧他的手,让我把手举起来,让我抬头,让我深呼吸,总之就是不消停。
②拔管:同事用吸痰管在导管里吸了几下,说以后少抽点烟,很多痰。吸痰是我感觉最痛苦的时候,感觉肺被抽真空了…然后他扯断了套囊,把导管拔出来了。整个世界都平静了,我又睡着了…醒来发现,从开始到结束,整个过程1.5个小时,我感觉度过了一个世纪。


总结体验:

1、人的意志力是无法抵抗全麻的,诱导时,我竭尽全力试图保持清醒,然并卵。
2、过程真的很舒服,我知道自己一直都在做梦,好像做了一个很长很长的梦,在现实中不能实现的愿望在梦里都实现了。但我现在完全不记得梦到了啥,反正我最后醒的时候,万分不乐意。
3、醒来时气管导管的尤其是吸痰时刺激很大,不过还在我的忍受范围。


作为麻醉医生的心得体会:

1、术前把详细麻醉过程告诉患者,让他心里有数,对麻醉的平稳极有好处,可以减少术前恐慌和术后的恐惧,对术后谵妄也有一定预防作用。

2、患者术前戒烟一周,哪怕一两天,对患者也有好处,痰不会那么多,至少减少了吸痰次数,减轻了痛苦。(当然长期戒烟最好,我不鼓励抽烟)

3、在插管时气管导管涂抹达克罗宁或者利多卡因软膏,可以增加患者的耐管程度,减少插管时的气道高反应,同时,拔管后嗓子不太难受。


补充说明:

1、全麻诱导,我常规用咪唑安定增加镇静,但此药有顺性遗忘作用,我怕用了之后我不能回忆起我的感受,所以没用。
2、真实患者,肯定有不同程度的手术创伤,麻醉药的用量和用法因人而异,不可参考本文,切记!
3、真实患者,麻醉和手术是很严谨的事情,不要向本文学习。
4、本实验所有人工都是自愿和免费,所有耗材和药品都由科室实验经费支出。


麻醉过程中发生的趣事:

1,万恶的同事把我的脉氧降到70才插管,我可能因此脑缺氧,智商从180降到了150,我永远恨你。
2,无耻的同事想趁我睡着时把我变成青龙(备皮),幸亏主任出面制止,否则我如何向我老婆交代!
3,猥琐的同事想给我插导尿管,幸亏护士长挺身而出,护士长我爱你!
总结:
①不要相信同事!
②不要相信同事!
③不要相信同事!

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  1. [GetPortalCommentsPageByObjectIdResponse(id=2170731, encodeId=c58b21e073181, content=真的很危险⚠️, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/AF43A7988964C1346E091DE08822DCC1/100, createdBy=1b2b1959838, createdName=jiazhoudexue, createdTime=Fri Nov 24 12:56:26 CST 2023, time=2023-11-24, status=1, ipAttribution=广东省), GetPortalCommentsPageByObjectIdResponse(id=201376, encodeId=5d342013e64b, content=感谢分享一下!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=20971999626, createdName=laymankey, createdTime=Tue May 23 00:02:48 CST 2017, time=2017-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1476542, encodeId=1af014e654294, content=<a href='/topic/show?id=6ff229e7126' target=_blank style='color:#2F92EE;'>#全麻#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29771, encryptionId=6ff229e7126, topicName=全麻)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Mon Jul 25 09:50:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94461, encodeId=91979446148, content=学习学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sun Jul 24 09:53:00 CST 2016, time=2016-07-24, status=1, ipAttribution=)]
    2023-11-24 jiazhoudexue 来自广东省

    真的很危险⚠️

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=2170731, encodeId=c58b21e073181, content=真的很危险⚠️, beContent=null, objectType=article, channel=null, level=null, likeNumber=17, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/AF43A7988964C1346E091DE08822DCC1/100, createdBy=1b2b1959838, createdName=jiazhoudexue, createdTime=Fri Nov 24 12:56:26 CST 2023, time=2023-11-24, status=1, ipAttribution=广东省), GetPortalCommentsPageByObjectIdResponse(id=201376, encodeId=5d342013e64b, content=感谢分享一下!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=20971999626, createdName=laymankey, createdTime=Tue May 23 00:02:48 CST 2017, time=2017-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1476542, encodeId=1af014e654294, content=<a href='/topic/show?id=6ff229e7126' target=_blank style='color:#2F92EE;'>#全麻#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29771, encryptionId=6ff229e7126, topicName=全麻)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Mon Jul 25 09:50:00 CST 2016, time=2016-07-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=94461, encodeId=91979446148, content=学习学习!, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=93f31631454, createdName=1dd8c52fm63(暂无匿称), createdTime=Sun Jul 24 09:53:00 CST 2016, time=2016-07-24, status=1, ipAttribution=)]
    2017-05-23 laymankey

    感谢分享一下!!

    0

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    2016-07-24 1dd8c52fm63(暂无匿称)

    学习学习!

    0