Interpretation of anesthesiology by famous doctors

Moderator: Different choices, different lives. Hello, audience friends. Welcome to professional navigation. I'm Lutong. When it comes to getting sick, people may think of hospitals and doctors. Well, if you are seriously ill, you may need surgery besides injections and medicine. So if you really want to have an operation, I'm afraid everyone will think of two doctors. One is a surgeon and the other is an anesthesiologist. Then why is an anesthesiologist so important? I think the reason is simple. You certainly don't want to wake up too early because of insufficient dose during the operation. Then the major we are going to introduce to you today is anesthesiology. Meet the guests who came to the show. Wang Weimin, MD, Director of peking university health science center Education Center, Chief Physician of Surgery, Peking University First Hospital.

Wang Dongxin, MD, Director of Anesthesiology Department of Peking University First Hospital, Deputy Director of Anesthesiology and Critical Care Medicine Department of Peking University, and Deputy Director of Clinical Medicine Research Institute of Peking University First Clinical College.

Moderator: Director Wang, the position of anesthesiologists is getting higher and higher in the eyes of our people. Because everyone is afraid, there is any problem with anesthesia during this operation. Does this also mean that anesthesia is a high-tech link?

Director Wang: I think this medical major should be said to be a high-tech major. Because we are dealing with people themselves, in fact, people are paying more and more attention to their health. I think this is also the reason why more and more people pay attention to doctors.

Moderator: Director Wang, I know that you have been engaged in anesthesiology research for many years. Can you tell us what kind of discipline anesthesiology is?

Director Wang: Anesthesiology, in fact, mainly refers to the method of using drugs or some method to make patients lose consciousness locally or completely, so as to spend the operation period painlessly. Then it is very important to ensure the comfort and safety of patients.

Moderator: What does Director Wang think is the most important criterion for being an excellent anesthesiologist?

As an anesthesiologist, first of all, I think I should have a very rich background in clinical medicine. Only by mastering these backgrounds can we become an excellent anesthesiologist. At the same time, from the anesthesiologist's point of view, you can use your own anesthesia appropriately to cooperate with the surgeon's operation. This should be a basic requirement.

Moderator: Did the operation really fail? For example, will the patient wake up before the operation is finished?

Director Wang: Of course, it is possible in theory. This requires the anesthesiologist to choose a reasonable anesthesia method, use anesthetic drugs correctly and give appropriate anesthesia dose according to the operation situation and the patient's situation. To ensure that patients can successfully spend the whole operation time, it is not to say that during the operation, as you said, the operation is not over, and the anesthesia has ended.

Moderator: For example, under what circumstances can a patient wake up before the operation is over?

Director Wang: Strictly speaking, anesthesia means that the patient can't wake up until the operation is finished. But there are some special operations. Maybe we need to wake up the patient during the operation. For example, plastic surgery is called spinal plastic surgery. In other words, the spine was deformed, and we corrected him. His risk is relatively high, mainly because it may cause the loss of spinal cord. In order to avoid this situation, orthopedic surgeons sometimes want to wake up from anesthesia during the operation to see if the patient's physical activity is still normal. But in general, anesthesia can only be completed after the operation.

Moderator: But during this operation, if the dose of anesthetic is small, will this patient really wake up? The operation was not completed.

Director Wang: Of course, if the dose is insufficient, the patient will wake up.

Moderator: What's the effect of overdosing?

Wang Dongxin: This is the side effect of narcotic drugs. In fact, any medicine has side effects. The dosage of drugs used by our anesthesiologists must be within the allowable range. If the dosage is exceeded, any drug may be fatal.

Moderator: I once read a report that a woman in her fifties in Shenyang had a cosmetic wrinkle removal operation. It was because of the unfavorable anesthesia that she finally became a vegetable. So we all say that if this kind of anesthesia is used well, it may reduce the pain of patients, but the consequences caused by poor use are also very serious.

Director Wang: That's true. So this requires anesthesiologists to master all kinds of anesthesia operation skills skillfully. You must be familiar with the indications, contraindications, side effects and commonly used doses of various narcotic drugs.

Moderator: I know about anesthesiology. I don't know if you still remember such a fragment in Water Margin (TV series). At the end of the Northern Song Dynasty, after Song Jiang led Liangshan heroes to surrender, he suffered heavy casualties as an imperial army. Let's take a look at this clip in the TV series.

Director Wang: There was no anesthesia at that time. If you want to have an operation, you can only endure the pain. It should be said that anesthesia in the modern sense began after the 1950s of 19. In fact, you have seen the previous books about surgery. In fact, they mainly talk about some very simple operations. Because there was no anesthesia at that time, it was impossible to do too complicated surgery. In our country, we know that Bian Que was first in the Spring and Autumn Period. According to the literature, he used poisoned wine to put the patient to sleep for surgery. Then in the Eastern Han Dynasty, Hua Tuo also used something similar to hemp boiling powder. In order to make the patient fall asleep, there was no pain in the operation. But these historical records are very simple, and future generations have not continued to do so.

Director Wang: It should be said that before19th century, anesthesia was very crude and unsafe. Of course, its anesthetic effect is not very ideal.

Moderator: Is it as early as our country's history of developing anesthesiology in the world?

Director Wang: It should be said that anesthesia in the modern sense in our country was introduced into China with the introduction of western medicine. This period of history should be said to be later than the west.

Moderator: Director Wang, take a look at the development of anesthesiology. We also used several keywords in the screen to summarize the development of anesthesiology. Can you tell us about the development of anesthesiology with this keyword?

Director Wang: The development of anesthesia is due to the pain caused by surgery or trauma. So painful, of course, human beings have encountered it for a long time. But in the Middle Ages, we didn't have many ways to relieve pain. There were many inhuman methods at that time. For example, use ice cubes to make limbs unconscious. Another way is to tie the limbs tightly with a belt to numb them. This method seems barbaric. And it will cause a lot of serious injuries.

Director Wang: Later, people thought of various ways to deal with pain. For example, early people found that plants containing opioids were used. Datura stramonium and other plant extracts have analgesic effect. Some people use alcohol to make patients feel drunk, trying to alleviate the pain of surgery. Of course, these methods are immature, unsafe and have great side effects. So until the modern sense of anesthesia, which is our second key word ether. The production of ether produced anesthesia in the modern sense. The use of ether is a milestone in the history of anesthesia. What about the use of ether? It can be traced back to1846101October 16. At Massachusetts General Hospital in Boston, USA, people used ether for anesthesia for the first time. After that, ether anesthesia spread rapidly. Later, the clinical application of ether continued for 100 years. Ether has been used for such a long time, of course, because some of its characteristics can make patients safely pass the operation stage.

Director Wang: As for opium, many of us know that opium was learned from the historical story of the Opium War. In fact, opium, which contains an ingredient called opium, has a good analgesic effect. In fact, this painkiller has been used to relieve surgery for a long time. For example, morphine is still a very common opioid. So although morphine has a long history of application, it still plays an important role in clinical analgesic treatment.

The use of muscle relaxants is a little later than the use of ether. In fact, muscle relaxants were originally used in clinic, such as something called tubarine. In fact, this kind of thing was found from American Indians, because westerners found Indians, pressed a medicine on the arrow and took it to shoot animals. As a result, animals become immobile. Later, it was found that this drug can produce muscle relaxation effect if given to patients who have been anesthetized. Then this can create better surgical conditions for the operation. Therefore, the introduction of muscle relaxants into clinic has greatly improved the safety of anesthesia. Because of muscle relaxants, we don't need to do deep anesthesia to meet the needs of surgery. Speaking of safety and comfort, this is actually the purpose of anesthesia. In other words, anesthesia is to make patients safely and comfortably undergo surgery. This has always been the goal pursued by anesthesiologists.

Moderator: With the continuous development of anesthesiology, we also need to train a large number of talents in this field. So, Director Wang, is there any talent in this field in China?

Director Wang: As far as I know, there are about a dozen colleges and universities in China that offer anesthesiology majors and recruit students majoring in anesthesiology.

Moderator: For example, what institutions are there?

Director Wang: For example, there are Central South University and Sun Yat-sen University, such as Binzhou Medical College.

Moderator: That's just like what kind of courses students can get in touch with if they enter the Peking University Medical Center.

Director Wang: There is no anesthesiologist in Peking University Medical College. Our anesthesiologists come from clinical medicine. These students have been studying in Peking University Health Science Center for eight years, so-called bachelor's and doctoral degrees. In the course of these eight years, his basic work and rest time is roughly divided into two years of pre-medical stage, with Beida as the base. Then there are two years of basic medicine, at the headquarters of the medical department. For the next four years. Three whole blocks. In the pre-medical stage, natural science, social science and humanities are mainly offered to improve students' comprehensive quality. In the basic stage of medicine, there are two courses, one is morphology and the other is function. Among them, anesthesiology is taught in general surgery.

Moderator: It is in the clinical stage that all the courses we study are the same. I separated when I was a freshman.

Director Wang: Generally, after we have studied all the women at home and abroad, we have an internship for one year. After the internship, some students choose anesthesiology, about three or two and a half years.

Moderator: Director Wang, what do we need to learn in a course like our anesthesiology major?

Director Wang: We are in the undergraduate teaching stage, and the course of anesthesia mainly includes these four aspects. Introduction to anesthesiology, general anesthesia, local anesthesia and cardiopulmonary resuscitation.

Director Wang: Next, the introduction will talk about the history of anesthesia and some contents including preoperative preparation. As for general anesthesia, it will introduce commonly used general anesthesia drugs and various surgical methods related to general anesthesia. These anesthesia stages. Then the local anesthesia part will introduce the drugs used in local anesthesia and the commonly used local anesthesia methods. Such as spinal anesthesia, nerve tissue anesthesia and so on. Then cardiopulmonary resuscitation mainly introduces what kind of work should be done when an emergency like cardiac arrest occurs. Therefore, cardiopulmonary resuscitation has traditionally been one of the important tasks of anesthesiologists.

Moderator: Well, after learning some basic information about anesthesiology, let's see what related questions netizens have raised about our major.

Moderator: A friend from Beijing named Li Bin asked if it was good to study anesthesia and find a job.

Director Wang: As far as I know, there is actually a gap in the demand for anesthesiologists. We know that the number of operations in many hospitals is also increasing rapidly, which means that these hospitals will also have a demand for anesthesiologists. In some ways, this anesthesiology department is not only engaged in anesthesiology itself, but also can go to some nearby specialties, such as intensive care unit and emergency room, which also require the work of anesthesiologists.

Moderator: OK, let's look at the next question. Nanchang called Gutu's friend. He said that how many students of Beijing Medical University will become anesthesiologists after graduation?

Director Wang: Generally speaking, students of Beijing Medical University are assigned to a higher level after graduation, so it is estimated that 5%- 10% of students may be engaged in anesthesiology every year, that is, about 30 to 40 students.

Moderator: Look at a friend of Xi 'an named Juanzi. He said he heard that some anesthetics are addictive. Is that so?

Director Wang: Some anesthetics are addictive. But the process of anesthesia should be said to be a very short process. As far as anesthesia is concerned, this drug is not addictive. The main reason of addiction is that long-term use for other reasons will lead to. Therefore, in anesthesiology, the probability of addiction is still very small.

Moderator: Chengde, please rest assured that my friend said that I am an elderly woman and want to have a caesarean section. Does anesthetic affect my baby?

Director Wang: This is a problem that many pregnant women are very concerned about. It should be said that our anesthesia method is very safe, and the anesthesia method we use has the least influence on mother and baby. The most commonly used methods, such as spinal anesthesia, are recognized as methods with little influence. Of course, some patients need general anesthesia, but we also try to choose these anesthetic drugs that have little effect on the fetus. It should be said that under normal circumstances, these effects are completely acceptable.

Moderator: OK, I believe that through the introduction of two teachers, everyone should have a further understanding of anesthesiology. Then if you like medicine and are interested in anesthesia, this major should be a good choice. Well, thank you two teachers for being our guests. What you are seeing now is professional navigation. Thank you for watching. See you next time.