Doctor: I picked up attributes in the hospital

Chapter 105 The Legendary Blind Piercing?

Seeing Zhao Heng's serious face, Xiaohong and his wife also began to feel uneasy.

The couple looked at Zhao Heng eagerly, for fear that he would say that he could not be anesthetized.

"Doctor... I... Can my daughter-in-law be anesthetized?"

Xiaohong's husband stuttered and asked nervously.

"It can be anesthetized, but we need to develop a comprehensive anesthesia plan, which will take time."

Zhao Heng thought for a moment, then said slowly.

There are many difficulties in completing anesthesia for this super parturient.

First, due to excessive obesity, the patient has high blood pressure and a heavy heart load. According to Zhao Heng's observation, even in a resting state, the patient's breathing is not smooth.

This determines that during preoperative anesthesia, too much muscle relaxant should not be used, otherwise it will inhibit the patient's breathing.

Second, there is the issue of puncture.

According to Zhao Heng's visual inspection just now, the thickness of the fat layer on the patient's back must have exceeded that of the puncture needle.

The fat thickness of ordinary people is 4-5cm, and the fat thickness of obese people is 6-7cm. However, the fat thickness of this super pregnant woman is at least 10cm, while the length of the ordinary anesthesia needle is only 8.5cm.

In this case, not only is it difficult to find the puncture site, but it is also likely that the puncture needle cannot penetrate the fat and enter the epidural space due to the thick fat layer.

"Thank you, thank you doctor."

When Xiaohong and his wife heard Zhao Heng say that they could be anesthetized, they immediately felt as if they had received an amnesty, and they said very excitedly.

This child embodies the hope of the couple for a lifetime.

"Take a good rest."

Zhao Heng nodded and said.

Naturally, he could see the excitement of the couple.

Soon, Zhao Heng and He Wei left the ward and returned to the office.

He Wei poured a glass of water for Zhao Heng, and then slowly said: "Actually, when this woman came, we didn't advise her to give birth. She was so obese, and the burden on her heart was heavy. During the delivery, it was very difficult. It may lead to heart disease. But the couple insisted too much, so I thought of seeing Dr. Zhao for a consultation."

"Based on this patient's condition, it is extremely difficult to get pregnant. It's not surprising that she persists so much."

Zhao Heng took a sip of water, nodded and said.

"Yes, it can be said that it is very likely that this is the only time in the patient's life that she is pregnant."

He Wei said in agreement.

"In terms of cesarean section, is it difficult?"

Zhao Heng thought for a while and asked He Wei.

Being an anesthesiologist is not that simple. Before anesthesia, one must have a comprehensive understanding of the anesthetized subject.

"The fat layer on the patient's body surface is too thick to cut open, but this is not the biggest difficulty. I am worried that the patient's heart will not be able to bear the load of childbirth during the operation."

He Wei thought for a while and said.

This is also the reason why she asked Zhao Heng for consultation. Although the operation of this super pregnant woman was difficult, as a senior obstetrician at Dongfang Hospital, He Wei thought she could still win this operation.

The most critical thing is the problem of cardiac load and anesthesia for patients during the operation.

"Yes, I have observed that the patient struggles to breathe in a resting state. If muscle relaxation is used during the operation, apnea is likely to occur at any time. The most important thing is that the patient's back fat The layer is too thick, according to my estimation, it is likely to have exceeded the length of the puncture needle."

Zhao Heng continued.

"Then Dr. Zhao, the anesthesia for this patient?"

He Wei asked hesitantly.

The difficulty has already been placed here, and the risk is also extremely high. If Zhao Heng does not accept the patient's anesthesia, it is understandable.

"Anesthesia is possible, but a detailed anesthesia plan needs to be formulated. In the past two days, Dr. He, please apply for a bedside B-ultrasound machine from the B-ultrasound room."

Zhao Heng thought about it seriously and said his suggestion.

"Bedside ultrasound equipment? Where is this used? Could it be that Dr. Zhao, you have found a way to solve the problem that the patient's fat layer is too thick to be punctured?"

He Wei asked with some doubts after hearing what Zhao Heng said.

"I just had an idea, wait for me to sort it out, and I will come back tomorrow."

Zhao Heng said.

"Well, then I will trouble you, Dr. Zhao."

He Wei said very politely.

Soon, Zhao Heng returned to the anesthesiologist's office in the operating room from the obstetrics department.

As soon as she entered the office, Xu Manni saw Zhao Heng with a serious face, and couldn't help asking, "What happened to the obstetrics department? Are there any difficult patients?"

"Well, it's a [-]-jin pregnant woman who needs to be anesthetized."

Zhao Heng said.

"Huh? Three hundred catties?"

Hearing this, Xu Manni and Sun Li's eyes widened.

Three hundred catties, what is this concept?
Under normal circumstances, under the condition of average height, the weight of an adult is generally about 130 to 140 catties.

These three hundred catties are almost the weight of two normal adults.

One can imagine the burden on the heart of being so obese.

"Yes, the most important thing is that the patient's back fat layer is at least 10cm by visual inspection, which is likely to exceed the length of a conventional puncture needle."

Zhao Heng said helplessly.

"This.."

Hearing this, Xu Manni and Sun Li didn't know what to say.

The length of the conventional puncture needle is 8.5cm, which is already considering the situation of obese patients. Generally, the thickness of abdominal fat in normal adults is only 3cm. One can imagine how exaggerated the thickness of this patient’s back fat layer is 10cm. A number is up.

"Such a thick fat layer, not to mention that conventional puncture needles cannot penetrate at all, even if the patient is so fat, it is difficult to find the body surface marks for puncture."

Xu Manni frowned and said.

Judging from the situation of this super parturient, it is almost a blind spot of anesthesia.

If you think about it for a while, you will know that not only can't find the body surface marks, but even the puncture needle can't penetrate it. How can it be anesthetized? !
"Based on this patient's condition, if anesthesia is necessary, it can only be performed blindly."

Sun Li said suddenly.

"Blind piercing? This technique only exists in legends, okay..."

Hearing what her best friend said, Xu Manni curled her lips and said.

The so-called blind puncture means that when the body surface marks cannot be found, the doctor performs the puncture with his own rich experience.

This not only requires the doctor's extremely rich experience, but also requires the doctor's incomparable proficiency in the anatomical structure of the human body.

Xu Manni has also worked in the operating room for many years. She has never seen the blind piercing that Sun Li mentioned only exists in theory.

"Actually, it's not total blindness. Total blindness is luck. You can use bedside B-ultrasound to find out the intercavitary space on the patient's body that is suitable for puncture. After recording the intercavitary space, you can perform the puncture."

Zhao Heng thought for a while and said.

"Huh? The human brain is not a computer, and the B-ultrasound is not a camera. This is not realistic at all."

Xu Manni felt that Zhao Heng's suggestion was a little unrealistic.

Because the images detected by the B-ultrasound are not very intuitive images, and doctors need to perform three-dimensional restoration in their minds.

What's more, even if it is restored, then remembering this position, you have to go through the thick layer of fat to accurately puncture to this position. This kind of difficulty is simply breaking through the sky.

In Xu Manni's impression, no one has ever done such a thing!

(End of this chapter)