Job of the anaesthesiologist begins some days prior to the operation. At first it gets acquainted with the case record of the patient. Then spends pilot survey of cardiovascular system, a liver and kidneys (appoints blood analyses), asks about an allergy on medicines, finds out details about the transferred and chronic diseases, the previous narcosises and operations. All it is necessary correctly to pick up anaesthesia.

calming conversation with the patient is important - and if it is the child and with his parents (differently their trouble will be passed the child and it will be heavier for shipping in a dream). One days prior to operation the anaesthesiologist comes and in conversation tries to support the ward. He softly explains, that will occur and why it is not necessary to be afraid of operation. It is besides important, that parents were not nervous also.

But here the patient appears in the operational block. In half an hour it is already ready to operation. At this time it can be in a deep dream or to be in consciousness, but in any case he should not feel a pain. The method by which the necessary status for operation is reached, carries the name …

… Anesthesia

Anesthesia there is the general , regionarnaja and local .

the General anaesthesia is all known "narcosis". Immersing in a narcosis occurs so. At first in a vein of the patient the preparation-gipnotik moves. Blood bears molecules gipnotika to a brain. The brain reacts to a preparation, and soon there comes a deep medicamentous dream. The patient will sleep till the end of operation and when will wake up, all already remains behind.

the Consciousness of the patient is disconnected, but its muscles all the same can be reduced, reacting to actions of surgeons. That surgeons could work easy, muscles of the patient it is necessary obezdvizhit. It is done by special substances - miorelaksanty which block a momentum transfer from a nerve to a muscle.

however, even being in a deep dream and being obezdvizhennym, the person all the same feels a pain. Therefore it is possible to start operation only after the third stage of a narcosis - anaesthesia. Painful impulses at a narcosis can be blocked or narcotic analgetikami, or anestetikami. Narcotic analgetiki “submit to the patient” through a vein. Gaseous anestetiki - through a mask; them use only at operations lasting not more than one and a half hours.

"pumped up" gipnotikami, miorelaksantami and anaesthetising the patient already on what does not react. Means, it is possible to start operation.

Regionarnaja anaesthesia is called so because anaesthetise only a part of a body of the patient. At central regionarnoj anesthesias anaesthetise the big sites of a body (for example, the bottom part of a trunk). At peripheral - a small site: a hand, a foot, a brush, foot. But also in that, and in other case a principle one. A solution local anestetika enter into area round a nervous bunch, blocking carrying out of painful impulses. Thus more often one is blocked not, and the set of nerves, each of which is responsible for the zone.

at central regionarnoj anesthesias the preparation is entered directly into the spinal channel, influencing on bunches of the nerves leaving directly from a spinal cord.

applying such anaesthesia, it is possible to do without full obezdvizhivanija the patient and, basically, even without immersing in a dream. However procedure of anaesthesia is unpleasant, and at times even is painful. And for the child it also trudnoperenosima because it you will not force to lay easy some minutes. Besides during operation the patient all will hear. Means, it is better to lull him all the same.

local anaesthesia apply only at small surgical interventions (for example, birthmark removal) and only at the consent of the patient or his parents. Preparations use the same, as for regionarnoj anesthesias. Only in this case large nervous bunches, and painful receptors in the field of prospective operation are blocked not. Such anaesthesia is done by surgeons, but it is obligatory in the presence of the anaesthesiologist.

There are surgery areas, where a narcosis - a unique possible method of anaesthesia. It is neurosurgery, kardiohirurgija, vascular surgery, torakalnaja surgery (operations on thorax bodies) - the hardest interventions at which the full control over the patient is necessary.

in less difficult cases the doctor chooses a way of anaesthesia at own discretion, considering, certainly, a status of the patient. Someone considers, that is better the general anaesthesia, someone is assured, that the future - for regionarnoj. The third which the author concerns also, believe, that it is necessary to combine these methods, reducing thereby application of narcotic and hypnotic preparations and, accordingly, harm for an organism.

hands on pulse

During all operation the anaesthesiologist watches closely concentration in blood of preparations which are entered intravenously. If concentration becomes above maximum permissible, heart can stop. In that case the anaesthesiologist immediately does indirect massage of heart. In most cases heart comes back to normal job.

while there is an operation, the anaesthesiologist constantly is at a head of the patient. It supports a narcosis or checks, whether the mask tightly adjoins. Watches indicators of devices and the monitor to which the patient is connected, - behind arterial pressure, pulse, a body temperature, saturation of blood by oxygen.

it is final, he cannot foresee, it should face what complexities. If the situation threatens a life of the patient the anaesthesiologist and the surgeon stop operation.

serious (with threat for a life) during operation it is a lot of complications - cardiac arrest, damage of lungs, rise in temperature and so on. But there are they extremely seldom.

if all goes normally, the patient leaves a narcosis after operation. Reflexes come back, muscles start to be reduced, there is an independent breath. The anaesthesiologist should come into contact with the patient - to talk to it, to ask to open it eyes and to answer questions.

After the patient left a narcosis, it send in branch and if operation went more than three hours in resuscitation where he definitively wakes up. As it is independent it to breathe cannot yet artificial ventilation of lungs proceeds.

in its chamber bring the sleepy: in an organism still there are preparations-gipnotiki. To rise from a bed before full awakening it is impossible. After a narcosis the vestibular mechanism is not perfectly in order - the person badly co-ordinates the movements and can fall. Therefore it is better to lay before full restoration of consciousness and the control over a body. Whether

anaesthesia is dangerous?

Completely the harmless and safe method of anaesthesia is not present. Preparations for a narcosis strongly load a liver (which deduces them from blood) and hurt hepatic cages. If the same patient be immersed in a narcosis more often an once in a month, at it the jaundice, and further and a cirrhosis can develop. Gets also to cardiovascular system, in particular heart. Some actions of the anaesthesiologist can lead to a trauma - for example, inaccurate introduction of a tube in a trachea for artificial ventilation of lungs.

At regionarnoj anesthesias usually apply gipnotiki (to "switch off" the patient ”) which negatively influence an organism. Besides, this method has complications. At carrying out of local anaesthesia it is possible to hurt casually a needle a nerve because of what the certain part of a body for a while can lose sensitivity. And at hit anestetika in blood spasms can begin and even temporarily stop breath.

and still regionarnaja anaesthesia is less dangerous, than a narcosis, however its application is limited for the several reasons. It and the developed stereotypes, and not always the trained personnel, including medical sisters. On use of many preparations-anestetikov for children does not give permission Farmkomitet of Russia. And in job of the anaesthesiologist the law operates - that is not authorised, it is forbidden. In summaries to local anestetikam register age of the patient - usually “from 12 years”. That is to children the majority local anestetikov is more younger 12 years "are not shown". And not because they are harmful, that is why, that up to the end are not investigated. Therefore for children anaesthesiologists are more younger 12 years are compelled to use preparations with small period of validity (till one and a half o`clock). And if operation lasts longer, it is necessary to do a narcosis.

local anaesthesia not so is harmful to an organism as regionarnaja or the general - it is final if there are no complications. Among them - an allergy on a preparation, preparation hit in blood. Besides, surgeons (especially children`s) not so like local anaesthesia - after all the patient is in consciousness and can see all operation. That sometimes calls it a shock leading subsequently to frustration of mentality.

in medicine there are no harmless preparations. If to you say, that the preparation is harmless, it does not operate is a law. The organism is a difficult system with a large quantity of adjustable parametres. Any medicine yes influences something negatively.