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With it, obese patients no longer worry about it.
.
.
At 16:20 on July 11, 2018, the weight loss operation of "China's fattest" Wang Haonan was successfully completed.
Relatives who waited in the corridor for more than 8 hours , The big rock in my heart finally fell to the ground.
Before the operation, however, it is not that simple to perform a weight loss operation on the 668 kg of "China's No.
1 Fatty".
Liu Shaozhuang, a weight loss and metabolic surgeon at Qilu Hospital of Shandong University, said: “This weight loss operation is not what some people imagine that the patient will lose weight immediately through the operation, but a sleeve gastrectomy, which can also be called a'stomach reduction.
technique '.
More simply, the stomach is cut from the tubular shape of a bag, into a "banana stomach.
"To complete such a difficult operation, anesthesia is an indispensable, but it is also a link that tests the doctor.
The
doctor is giving Wang Haonan the application of muscle relaxation drugs to relax the skeletal muscles to meet various operations and tracheal intubation .
Tubes require muscle relaxation and reduce the amount of general anesthetics.
For example, the laparoscopic surgery received by Wang Haonan has very high requirements for the degree of relaxation of the abdominal muscles of the patient, which cannot be achieved with a single sentence of "relaxation".
"Specifically, when we calculate the amount of medication before the operation, we cannot simply take the medication based on his actual weight, but exclude the weight of the fat part before calculating the dosage.
"Said Yu Jingui, director of the Department of Anesthesiology, Qilu Hospital of Shandong University.
In addition, many patients undergoing general anesthesia during abdominal surgery have residual neuromuscular blockade after extubation, that is, residual muscle relaxation.
Respiratory muscles, tongue, throat, etc.
may appear .
Symptoms of muscle weakness in the area, leading to insufficient breathing power, inability to discharge pharynx and airway secretions, and other postoperative complications, which may be life-threatening in severe cases. In order to prevent the occurrence of similar situations, anesthesiologists generally adopt two methods: 1.
Extend the patient's stay in the postoperative recovery room, and return the patient to the ward after the neuromuscular blockade has completely subsided; 2.
Use muscles Pine antagonists, such as neostigmine, indirectly exert neuromuscular blockade and antagonism.
However, muscle relaxant antagonists are more likely to be incompletely antagonized in obese patients, which greatly increases treatment costs and risks, and may even enter the ICU in severe cases.
Successful weight loss after surgery So, are there any specific muscle relaxant antagonists that are more effective and safer? Shugeng Sodium Gluconate opens a new era of no residual muscle relaxation after surgery.
The answer is: Yes! Shugeng Sodium Gluconate is a new type of steroidal non-depolarizing muscle relaxant antagonist, which can effectively and specifically antagonize deep and moderate neuromuscular block.
The Expert Consensus on Perioperative Management of Weight Loss Metabolic Surgery (2019 Edition) clearly states that patients with obstructive sleep apnea (OSA) are at risk of airway obstruction after the tracheal tube is removed, especially incomplete muscle relaxants.
Antagonism will increase the risk of postoperative pulmonary complications.
Therefore, for these patients, short-acting muscle relaxants and (or) muscle relaxant antagonists with minor adverse reactions should be used with caution.
And it is recommended to use muscle relaxation monitoring to guide the use of muscle relaxation antagonists.
The consensus also emphasized that Sodium Gluconate (2 to 4 mg/kg) can eliminate the blocking effect of rocuronium within 3 minutes, so that the patient can restore muscle strength and sufficient tidal volume before waking up.
In a pivotal global clinical study, subjects were given rocuronium or vecuronium to maintain deep neuromuscular blockade, and randomly administered 4 mg/kg at the time of post-tonic stimulation (PTCs) 1-2.
More sodium gluconate or 70ug/kg neostigmine.
The results showed that the subjects who were anesthetized with rocuronium bromide and used sugammadex sodium, the median time from the start of sugammadex sodium until the T4/T1 ratio returned to 0.
9 was 2.
7 minutes, and neostigmine was used The subjects need 49.
0 minutes.
Similar results can also be seen in the subjects anesthetized with vecuronium—the sugammadex group recovered in 3.
3 minutes, and the neostigmine group recovered in 49.
9 minutes. The results of another pooled analysis that included 27 studies showed that there was no difference between the muscle relaxation recovery time of sugammadex sodium used in obese patients and non-obese patients, and there was no significant correlation between muscle relaxation recovery time and BMI.
From this point of view, for obese patients, Sodium Gluconate is a good solution to the problem of excessively long recovery time due to the large-scale use of muscle relaxants.
Shugengluconate sodium also makes it possible to maintain deep muscle relaxation during the operation, reducing the pressure of the pneumoperitoneum to 8-10 mmHg.
This will be more conducive to the early extubation and rehabilitation of patients, speed up the turnover rate of the operating room, and promote the management of accelerated rehabilitation surgery (ERAS).
It can be said that Shugeng Sodium Gluconate not only brings good news to obese patients, but also gives anesthesiologists more choices.
It is believed that the Sodium Gluconate Sodium will benefit more obese patients in the future! Source: "Medical Circle" Official Account Editor: Zheng Huaju
.
.
At 16:20 on July 11, 2018, the weight loss operation of "China's fattest" Wang Haonan was successfully completed.
Relatives who waited in the corridor for more than 8 hours , The big rock in my heart finally fell to the ground.
Before the operation, however, it is not that simple to perform a weight loss operation on the 668 kg of "China's No.
1 Fatty".
Liu Shaozhuang, a weight loss and metabolic surgeon at Qilu Hospital of Shandong University, said: “This weight loss operation is not what some people imagine that the patient will lose weight immediately through the operation, but a sleeve gastrectomy, which can also be called a'stomach reduction.
technique '.
More simply, the stomach is cut from the tubular shape of a bag, into a "banana stomach.
"To complete such a difficult operation, anesthesia is an indispensable, but it is also a link that tests the doctor.
The
doctor is giving Wang Haonan the application of muscle relaxation drugs to relax the skeletal muscles to meet various operations and tracheal intubation .
Tubes require muscle relaxation and reduce the amount of general anesthetics.
For example, the laparoscopic surgery received by Wang Haonan has very high requirements for the degree of relaxation of the abdominal muscles of the patient, which cannot be achieved with a single sentence of "relaxation".
"Specifically, when we calculate the amount of medication before the operation, we cannot simply take the medication based on his actual weight, but exclude the weight of the fat part before calculating the dosage.
"Said Yu Jingui, director of the Department of Anesthesiology, Qilu Hospital of Shandong University.
In addition, many patients undergoing general anesthesia during abdominal surgery have residual neuromuscular blockade after extubation, that is, residual muscle relaxation.
Respiratory muscles, tongue, throat, etc.
may appear .
Symptoms of muscle weakness in the area, leading to insufficient breathing power, inability to discharge pharynx and airway secretions, and other postoperative complications, which may be life-threatening in severe cases. In order to prevent the occurrence of similar situations, anesthesiologists generally adopt two methods: 1.
Extend the patient's stay in the postoperative recovery room, and return the patient to the ward after the neuromuscular blockade has completely subsided; 2.
Use muscles Pine antagonists, such as neostigmine, indirectly exert neuromuscular blockade and antagonism.
However, muscle relaxant antagonists are more likely to be incompletely antagonized in obese patients, which greatly increases treatment costs and risks, and may even enter the ICU in severe cases.
Successful weight loss after surgery So, are there any specific muscle relaxant antagonists that are more effective and safer? Shugeng Sodium Gluconate opens a new era of no residual muscle relaxation after surgery.
The answer is: Yes! Shugeng Sodium Gluconate is a new type of steroidal non-depolarizing muscle relaxant antagonist, which can effectively and specifically antagonize deep and moderate neuromuscular block.
The Expert Consensus on Perioperative Management of Weight Loss Metabolic Surgery (2019 Edition) clearly states that patients with obstructive sleep apnea (OSA) are at risk of airway obstruction after the tracheal tube is removed, especially incomplete muscle relaxants.
Antagonism will increase the risk of postoperative pulmonary complications.
Therefore, for these patients, short-acting muscle relaxants and (or) muscle relaxant antagonists with minor adverse reactions should be used with caution.
And it is recommended to use muscle relaxation monitoring to guide the use of muscle relaxation antagonists.
The consensus also emphasized that Sodium Gluconate (2 to 4 mg/kg) can eliminate the blocking effect of rocuronium within 3 minutes, so that the patient can restore muscle strength and sufficient tidal volume before waking up.
In a pivotal global clinical study, subjects were given rocuronium or vecuronium to maintain deep neuromuscular blockade, and randomly administered 4 mg/kg at the time of post-tonic stimulation (PTCs) 1-2.
More sodium gluconate or 70ug/kg neostigmine.
The results showed that the subjects who were anesthetized with rocuronium bromide and used sugammadex sodium, the median time from the start of sugammadex sodium until the T4/T1 ratio returned to 0.
9 was 2.
7 minutes, and neostigmine was used The subjects need 49.
0 minutes.
Similar results can also be seen in the subjects anesthetized with vecuronium—the sugammadex group recovered in 3.
3 minutes, and the neostigmine group recovered in 49.
9 minutes. The results of another pooled analysis that included 27 studies showed that there was no difference between the muscle relaxation recovery time of sugammadex sodium used in obese patients and non-obese patients, and there was no significant correlation between muscle relaxation recovery time and BMI.
From this point of view, for obese patients, Sodium Gluconate is a good solution to the problem of excessively long recovery time due to the large-scale use of muscle relaxants.
Shugengluconate sodium also makes it possible to maintain deep muscle relaxation during the operation, reducing the pressure of the pneumoperitoneum to 8-10 mmHg.
This will be more conducive to the early extubation and rehabilitation of patients, speed up the turnover rate of the operating room, and promote the management of accelerated rehabilitation surgery (ERAS).
It can be said that Shugeng Sodium Gluconate not only brings good news to obese patients, but also gives anesthesiologists more choices.
It is believed that the Sodium Gluconate Sodium will benefit more obese patients in the future! Source: "Medical Circle" Official Account Editor: Zheng Huaju
