super anesthesiologist

Chapter 1 Aneurysm Ruptured!
S University Medical College Affiliated Hospital, Catheterization Laboratory Observation Room of the Imaging Department.

Lin Xiaobei sat at his desk and stared at the monitor screen intently. He was an anesthesiologist.

In the operating room separated by the leaded glass protective wall, a seemingly ordinary but extremely risky operation-aneurysm embolization is being performed.

The operation was proceeding smoothly as scheduled, and the patient's vital signs were normal and stable.

Suddenly the monitor issued a "beep" alarm!

林小北赶紧查看：HR 45（心率45次/分钟），BP 65/36（血压65/36mmHg）。

He remeasured, HR 42, BP 61/35!

"Director Jiang, please stop!" Lin Xiaobei shouted to Director Jiang Renze on the operating table through the glass wall through the walkie-talkie.As soon as he was promoted to the qualification of attending doctor, he won the trust of the director of the department, Lin Chaobing, and was in charge of such an important surgical anesthesia alone for the first time.

Absolutely nothing can go wrong!
"What's the matter? We're about to put the coils on." The chief physician Jiang Renze was very impatient when he was called to stop at the critical moment.

"The patient's heart rate is very low, 42 beats per minute, and his blood pressure is almost undetectable." Lin Xiaobei reported.

"What?" Director Jiang paused, as if he didn't hear clearly.

"The patient's heart rate is 42 beats per minute and blood pressure is 61/35mmHg." Lin Xiaobei had no choice but to repeat.

Director Jiang stood still on the stage. When the guide wire stimulated the baroreceptors in the carotid sinus, the patient's heart rate would slow down and blood pressure would drop. However, why did he say it now?
"What's up with you anesthetist?" he complained.

Lin Xiaobei said neither humble nor overbearing: "Director Jiang, I have been paying close attention to the patient's vital signs suddenly changed!"

"Okay, okay, deal with it quickly."

Lin Xiaobei entered the operating room after getting permission from the angiologist in the catheterization room, and rushed to the patient's side immediately.

He checked carefully, and found that the anesthesia machine was working normally; the connecting lines of all monitoring instruments were fine.

The maintenance anesthesia drug is the minimum effective dose set according to the calculation, and the data monitored by BIS (Bispectrum Index) fluctuates between 55-60 (100 in the awake state), which shows that the anesthesia depth at this time is moderate, The patient is in a very ideal state of anesthesia.

There is nothing wrong with the equipment, so the sudden abnormal vital signs of the patient may be related to the operation of director Jiang Renze on stage.

Lin Xiaobei's scalp went numb, he would not question him.Director Jiang Renze is the most famous and authoritative neurosurgery expert in the hospital and even in the city. Who dares to question his operation?
What he has to do is to deal with it in time and take corresponding rescue measures.

Immediately boost the pressure, MHJ (the narcotic drugs are mostly psychotropic drugs, in order to prevent being harmonized, they are all replaced by letters) 5mg.

Expand the volume and speed up the infusion speed.

Then watch closely and measure.

After 1 minute, the basic vital signs of the patient stabilized.

HR 58 beats/min, BP 95/61mmHg, SPO2 99%.
-
An acceptable and near-normal standard has been reached.

"Okay." Lin Xiaobei exhaled, he was really startled just now.

Director Jiang Renze calmed down when he saw that the patient was fine.

"Continue to observe carefully, Comrade Xiaolin."

"Yes, I see, Director Jiang."

Aneurysm embolization is a minimally invasive surgery that has just emerged recently to treat aneurysms in the human body.To put it simply, the guide wire is used to send the filling material (coil) to the aneurysm cavity, so that it loses blood supply and automatically shrinks and disappears, so as to achieve the purpose of treatment.

It seems simple, but in fact it is like sailing a boat in the sea, extremely dangerous.Any tiny mistake may cause the tumor to rupture, intracranial hemorrhage in a short period of time and rapid death.

The experience of the surgeon is extremely important.

The main person in charge of this operation, Jiang Renze, the well-known neurosurgery director of the affiliated hospital, has performed more than 100 cases of this type of operation, and his authority is beyond doubt.

According to the information obtained from the medical records, Director Li Changgeng is 46 years old this year, without high blood pressure, heart disease, diabetes, and other systemic diseases, and is in very good health.

The basic condition of the patient is also very good.

The condition of the doctor and the patient seemed to be impeccable.

But Lin Xiaobei's premonition was not good.

Because before I knew it, another two hours passed.

From the first stage of the operation, the guide tube was inserted through Director Li's right femoral artery, and then the microcatheter was slowly guided to the location of the aneurysm. Lin Xiaobei could see clearly the whole process and it went very smoothly. .

It stands to reason that this operation should be over soon, but until now Director Jiang Renze is still busy on the operating table nervously.

The damn deflector seemed to be against him on purpose, hovering and discounting at the front of the aneurysm.

Director Jiang Renze struggled on the stage for a long time, but the guide wire was still unable to enter the tumor cavity, let alone place the coil (GDC, electrolytic hemagglutination detachable platinum coil).

As time passed slowly, he clearly showed impatience.

But there is someone more anxious than him, Lin Xiaobei.

For an anesthesiologist, the longer the patient stays on the table, the more anesthetics will remain in the body, which is not conducive to postoperative recovery.And it will also cause other related complications, such as respiratory depression, unresponsiveness in a short period of time after surgery, and so on.

Pushing the responsibility to the anesthesiologist is almost the inertial thinking of all surgeons.

At that time, all postoperative complications will depend on myself. The operation is successful, but the quality of anesthesia is not good (the subtext is that the level of anesthesiologists is average).

Lin Xiaobei recalled Director Jiang's accusation: "What did you do, an anesthesiologist?"

His heart was icy cold. It was obviously his operation problem just now, but he could justifiably reprimand others.

But helpless.

As an anesthesiologist, what he can do now is to try his best to ensure that the patient's vital signs are normal and stable, and that he is in a proper anesthesia state, so as not to affect Director Jiang's operation on stage.

In the observation room, apart from Lin Xiaobei, there were material supplier Mr. Liu and radiographer Dr. Wang Jian.

Everyone was silently watching the video on the screen from the workshop. The damn deflector was still dancing in front of the aneurysm cavity, twisting into a ball, as if facing the gate of hell, refusing to enter.

Suddenly Lin Xiaobei's right eyelid twitched non-stop, and he had a very bad premonition.

Before he could figure out what was going to happen, his eyes were fixed on the monitor.

The image of the artery that was originally clear like a branch was blurred, and it spread rapidly like a black mist.

The tumor cavity in the shape of a black tadpole has been quickly engulfed by the black mist.

Director Jiang broke the aneurysm!
"God, this can't be true, can it?"

Lin Xiaobei wiped his eyes, yes, the black fog is getting thicker and thicker, indicating that the blood has started to leak from the aneurysm into the brain tissue.

Lin Xiaobei turned to look at the other two, also staring at the screen in horror.

Obviously they also found Ni Duan.

Director Jiang Renze on the workbench was trembling as if suffering from Parkinson's syndrome, his nimble hands were shaking constantly, and his forehead was covered with beads of sweat.

His assistant, Ye Heng, was pale with fright and was at a loss.

At this moment, the monitor issued various alarm sounds at the same time, piercing the silence of the catheterization room like a knife, sharp and piercing, prompting the patient's vital signs data to deviate rapidly from the normal range.

Director Jiang Renze was awakened by the sound of the siren, his face turned pale, and he shouted loudly to the observation room: "Hurry up and contact the operating room!"

He pulled out the guide wire from the patient's body, asked Ye Heng to press the bleeding wound, and said to him, "I'll explain the condition to his (patient Li Changgeng's) family members, and prepare to transfer the patient immediately."

After speaking, he hurried out of the catheterization room without even taking off his isolation suit.

Lin Xiaobei sighed inwardly, he didn't expect such bad luck.As long as the aneurysm ruptures, the patient is almost dead.The so-called sending to the operating room for craniotomy and decompressive craniectomy is just a helpless rescue, and it is difficult to change the outcome.

Although the patient's death has nothing to do with him, it is always very depressing to watch a living life suddenly disappear before his eyes.

He mechanically dismantled the monitoring equipment on the patient, and his eyes were in a trance.

Those instruments seemed to be riveted on Li Changgeng's body, and they couldn't be pulled out no matter what. The numbers on the monitor screen were like beating notes, and the beeping alarm sound was like sweet music.

He shook his head vigorously, but the dancing characters and the melodious vocal music became more vivid and real, and even the pale light in the catheterization room became softer.

He even saw Li Changgeng's smile and heard him say gratefully, "Thank you, Dr. Lin."

Is it hallucination?Lin Xiaobei asked himself in his heart.But why is the illusion so real?At the same time, he felt that his brain was muddled.

Could it be that he had shock syndrome?Simply put, this syndrome is the sudden onset of shock (commonly known as coma) for unknown reasons. No objective etiology and clinical examination evidence can be found. It is generally believed to be related to many factors such as the patient's own work pressure or life pressure.

When in shock, people will feel flustered, shortness of breath, chest tightness and discomfort, but Lin Xiaobei didn't feel this way at this time.In the daze, his brain was blank and steaming, a golden panel floated in it, and a few golden and eye-catching characters flashed on it: [The super anesthesiologist training system has been implanted successfully! 】

Super anesthesiologist training?system?
Lin Xiaobei didn't have time to think about it, and another line of characters flashed on the panel:
[The first test of the host's emergency response capability is limited to 5 minutes. 】

(End of this chapter)