Dr. Eric Freeman writes from China
Pictures from China by Dr. Eric Freeman
5/15/08 10:35 pm
Ahh eureka!….Could it be succinylcholine???
Another pleasant morning as I walked to the hospital. As I weaved around the onslaught of bicycles and mopeds coming towards me, I was thinking how I missed seeing the tabloid headlines of the New York Post every day back home. I thought that the Wall Street Journal had an international edition? I have yet to see one at a newsstand. I am resorting to looking at the pictures instead.
Today was another interesting one for me in China. Around 11am Dr. Cui came to my OR with Dr, Zhao (resident) and we headed down to the GI suite on the first floor. The patient was a VIP, transferred from another hospital for an ERCP. I was told he was a prominent Army General of the Jiangsu province. Besides being in his 80’s, all I was able to gather was that he had a significant cardiac and pulmonary history. A GI doc and another anesthesiologist from Shanghai came in specifically to assist in his care. Dr. Zhao and I prepared our set-up and drugs. As I glanced to my right were a few boxes of medications. I thought I was experiencing an acute episode of diplopia, as took off my glasses and rubbed my eyes. In front of my very 2 eyes was a box labeled “SUXAMETHONIUM CHLORIDE.” Like a kid opening a gift at Hannukah, I ripped opened the box and took a look. The usual glass vials, 2cc total, 50mg per cc. Finally after a week and a half I have seen the drug that is the bread and butter of every anesthesiologist armamentarium. Sux has been around since the 1950’s, I reckon, and has saved an astronomical number of lives. It felt like I was holding gold bullion. Also, there was box of etomidate and I drew up one vial, carefully not to cut myself on the glass. This etomidate, was white like propofol. Weird, compared to the stuff back in the old anesthesia cart I am used to drawing up every day in the heart room. I looked it up later and found out that this lipid emulsion version causes significantly less burning on injection compared to the propylene glycol version we give. Dr. Cui intubated this patient since he was a VIP. Not quite sure why the sux was used for induction since we later gave 2 mg of vecuronium. I stood by yet another anesthesia machine I was unfamiliar with. This one had all the buttons written in Chinese. I could figure out the basics but still needed some assistance. Unfortunately the ventilator was non-functional so I bagged the patient for one hour. Not much fun; at least I got a good forearm workout.
I took another stroll around the OR in the late afternoon. Cases were winding down. At 3pm there is no long queue to clock out like back home. I popped my head into a few rooms being a little nosy. I got a little freaked out as yet again, I saw that some patient’s had their eyes taped while some did not. Maybe it is true about the anatomy of the Chinese eye, and how their eyelids just naturally fall into place, but occasionally I could see part of the sclera.
A quick dinner then I headed back to the hotel to relax. I must have fallen asleep watching some badminton on TV as I glanced at my alarm clock to see it was 3AM.