Doctor: I picked up attributes in the hospital

Chapter 82 Difficulties Encountered in Digestive Surgery

Coming out of the operating room, Zhao Heng soon arrived at the Department of Gastroenterology and entered the office. The attending doctor Wei Tong, who had been sitting all the time, immediately stood up when he saw Zhao Heng coming in.

In Dongfang Hospital, the biggest news and hot spot recently is that Zhao Heng, the equipment supplier in the operating room, has suddenly emerged. At a speed that everyone has not realized, he has passed the anesthesiologist certificate, and he does not know what is the relationship. A formal anesthesiologist.

If that's the case, then everyone is just envious, but in the surgical department, all surgeons who have come into contact with Zhao Heng during the operation know that Zhao Heng's level of anesthesia is indeed very high.

At the same time of good luck, the level can still be so high, which is very admirable.

For this young talent with both luck and skill, doctors in major surgical departments are all concerned.

Wei Tong is no exception. As a surgeon, he has a deep understanding of how important an excellent and reliable anesthesiologist is during surgery.

An excellent and reliable anesthesiologist is the most solid backing for the surgeon.

"I'm sorry, Dr. Zhao."

Wei Tong said very politely.

Now Zhao Heng's status is different from before. If in the past, when Zhao Heng was just an operating room equipment maker, he could just call him Xiao Zhao.

But now Zhao Heng's identity is the same as his, and it is already an official hospital of Dongfang Hospital, so it is a bit inappropriate to call him Xiao Zhao, not to mention, he is now the one who invites Zhao Heng to come for consultation.

Interpersonal communication is sometimes so realistic. Invisibly, the difference in status, the attitude towards different people, and what to call them are all clear in everyone's mind.

"You're welcome, Mr. Wei. How is the patient's condition?"

Zhao Heng also nodded. This change in address and attitude is the most profound he has experienced recently.

In the past, he was a equipment supplier. Although he worked hard, he was not noticed at all. It can be said that he came and went when he was called. How could he be respected like he is now.

"The patient is an elderly woman, 70 years old, who was admitted to the hospital due to cholecystitis, acute pancreatitis, gallbladder sediment-like stones and common bile duct stones. Now she is considering gallbladder removal and common bile duct stone removal. The operation is not difficult, but the patient has many years of experience. He has a history of hypertension, coronary heart disease, and diabetes, as well as a history of chronic atrial fibrillation and cerebral infarction for many years."

Wei Tong quickly explained the difficult situation of the patient briefly.

Cholecystectomy and common bile duct stone removal are routine operations in digestive surgery, and the difficulty is not very high. It can be done in general city hospitals. This is very important for Wei Tong, the senior attending doctor of digestive surgery in Dongfang Hospital. Speaking, it's not a problem anymore.

But the most important thing is the surgical anesthesia for this patient. You must know that the patient is already old. Anesthesia is given to a patient who is already seventy years old. High-risk anesthesia.

What's more, the 70-year-old patient described by Wei Tong also suffers from hypertension, coronary heart disease and chronic atrial fibrillation. These basic diseases will greatly increase the risk of anesthesia and lead to serious complications during anesthesia.

That's why Wei Tongcai found Zhao Henglai, who had recently emerged in Dongfang Hospital and was good at handling complex and difficult anesthesia.

Zhao Heng's several difficult anesthesia operations in the previous surgery have been widely praised in the surgery department.

"Hypertension, coronary heart disease, and chronic atrial fibrillation..."

Hearing what Wei Tong said, Zhao Heng fell into deep thought. Indeed, this patient is indeed very difficult.

You should know that anesthesia drugs have the effect of paralyzing nerves and slowing down heartbeat and breathing. If the patient has chronic atrial fibrillation, the possibility of arrhythmia or even cardiac arrest during anesthesia will be very high. .

It's not easy.

Zhao Heng frowned slightly, feeling a little headache.

"Doctor Zhao, this patient's condition is really not suitable for postponing the operation, otherwise, I wouldn't have looked for you."

Seeing Zhao Heng's frown, Wei Tong also felt that he was a little bit embarrassed by Zhao Heng, so he couldn't help saying apologetically.

In fact, he also knew that the patient's condition was not suitable for anesthesia, but because of the doctor's hope, he still had to bite the bullet and ask Zhao Heng to have a look.

"It's okay. As a doctor, you have to think about the patient. In this patient's case, the difficulty of anesthesia is indeed very high, but it's not impossible."

Zhao Heng waved his hand, alleviating Wei Tong's embarrassment a little. They are all doctors, and they all consider patients, so there is nothing embarrassing or embarrassing.

You know, clinically, it is normal for all kinds of difficult situations to arise.

Sometimes, in a critical situation, you have to go if you have the conditions, but if you don’t have the conditions, you have to go if you create the conditions!

"I'm sorry, Dr. Zhao."

Hearing Zhao Heng's words, Wei Tong breathed a sigh of relief. It was really the patient's operation that could not be delayed.

The patient was already old, and if surgery was not possible and conservative treatment was used, it was very likely to cause gallbladder perforation and serious infection. What's more, the patient also had acute pancreatitis, which could be a life-threatening emergency at any time.

"For this patient, I think high epidural anesthesia can be used. In terms of anesthesia, ropivacaine and bupivacaine can be used, and epinephrine with a concentration of no more than 5 μg/ml can be used in the spinal canal, so that It can prolong the action time of local anesthetics, minimize the dose of systemic drugs, and avoid affecting the patient's heart rhythm."

Zhao Heng thought about it seriously, and combined with the experience from Gao Jun and Professor Huang Lao, he gave a very rigorous and detailed anesthesia plan.

High epidural anesthesia is generally used for postoperative pain relief.

However, for this patient, the use of high epidural anesthesia can reduce the dosage of general anesthetics, which can greatly reduce the impact of general anesthesia drugs on the heart rate, and minimize the chance of possible intraoperative complications.

"High epidural anesthesia? Yes! High anesthesia can be used."

Hearing what Zhao Heng said, Wei Tong thought for a while, his eyes lit up immediately, and he repeatedly agreed.

For this patient, if it is encountered by a general anesthesiologist, it will basically be judged that it is not suitable for anesthesia.

Because the difficulty of high-position anesthesia must start from the thoracic spine, the upper and lower spinous processes of the thoracic spine in the human body are imbricate, with narrow gaps, and the difficulty of puncture is very high.

What's more, the patient this time is a 70-year-old elderly man. The supraspinous ligaments of the elderly are calcified, and the spine will also have varying degrees of curvature, which will increase the difficulty of puncture anesthesia.

Elderly people have poor physical fitness and poor tolerance. Anesthesia must be in place at one time, but the difficulty of anesthesia puncture is increased.

Under various unfavorable conditions, it can be said that the anesthesia this time is very tricky. Under normal circumstances, a senior anesthesiologist who is not very experienced will definitely not be able to handle this anesthesia.

(End of this chapter)