super anesthesiologist

Chapter 36 Anesthesia Protocol (please collect, please recommend, thank you!!!)

Liu Xu bared a smile, "You are Supreme Treasure!"

"You are not Fairy Zixia!"

Lin Xiaobei said it casually, but Liu Xu's face was flushed like ketchup.There was an enthusiastic discussion just now, but now they are silent.

"Are you ready for tomorrow's anesthesia?"

He had nothing to say and asked her.

The silence made Lin Xiaobei feel uncomfortable, especially when he was very sleepy.At this time, if you don't try to mobilize your emotions, you will fall asleep again and again after a while.

Liu Xu handed him a notebook.

Lin Xiaobei opened it, and secretly admired it.

This girl's cleverness does not depend entirely on IQ, but her studiousness is also outstanding.

From the beginning of the text, the notebook records every detail of her anesthesia with Lin Xiaobei, including the rescue experience of that super fat man named Li Mengxia, the treatment of Wang Yuze who was run over by a truck, and the daily anesthesia after that. cases.

Mainly the preoperative preparation for anesthesia, induction scheme, intraoperative management, and postoperative experience.She writes every case in an orderly manner, with beautiful and neat handwriting, which looks very comfortable.

No wonder she improved so fast, Lin Xiaobei sighed: "Wow, you can write a medical novel by connecting these cases of yours."

"Nonsense, you should point out the shortcomings to me." Liu Xu said angrily.

"The downside is that this notebook is too simple, it's for us men. You girls should use that kind of diary that is very dazzling, for example, the lines inside are all pink, and there are cartoon pictures of Rukawa Kaede on it. "Lin Xiaobei joked.

"I'm not so boring, I'm not a little girl."

"In my eyes, you are just a little girl."

"Really?" Liu Xu smiled cutely and sweetly, but she quietly grabbed Lin Xiaobei's arm, and suddenly pinched it hard!
"Ah! You---" Lin Xiaobei was caught off guard, there were so many people in the operating room, he didn't dare to shout loudly, grinning his teeth in pain, this girl is really ruthless.

"Are all the little girls in the legend like this?" She said proudly.

"I didn't expect you to have such a fierce side."

"Who told you that you are not serious."

"How can you get married like this?"

"I want you to manage."

"Come on, whoever marries you in the future will be unlucky."

Liu Xu's little hand quietly stretched out again, but Lin Xiaobei was already on guard, and retracted before she grabbed it.

"Ms. Lin, I just want to touch your radial artery to find out how it feels." She said with a smile.

Lin Xiaobei didn't fall for her tricks, moved the stool away from her, opened the diary and continued reading.

In the last chapter, she recorded Wang Yuansheng's basic situation in detail, and made a detailed analysis of each disease, and then made the following anesthesia plan according to the results of the patient's examination:
Patient, Wang Yuansheng, male, 76 years old.

Diagnosis: intrahepatic bile duct stones, common bile duct stones, obstructive jaundice;
Surgery: open cholecystectomy, common bile duct exploration, partial hepatic lobectomy.

Basic diseases: 1 emphysema, pneumonia; 2 coronary heart disease; 3 hypertension; 4 spinal T8-9 tuberculosis; 5 diabetes (fasting blood sugar 9.3mmol/L); 6 multiple cerebral infarctions.

Prediction of Feasible Anesthesia Protocol:

1. General anesthesia, induction: 2mg of mildril, 10ug of SF, 100mg of acetaminophen pumped in, and 30mg of bromide.Visible after tracheal intubation, seven days inhalation and SF maintenance, after the operation, return to the ward or ICU according to the situation.

2硬膜外麻醉，因患者T8-9有结核病史，因此建议穿刺点选T5-6和T10-11双点法，分别向下和向上置管。

3 Local anesthesia, rectus abdominis injection, auxiliary, to minimize the interference of general anesthetics.

……

"Can you see how it's written?" Liu Xu leaned over, seeing Lin Xiaobei's seriousness, a little happy and a little shy.

"It's well written." It's not easy for a newcomer to write such an anesthesia plan.

"How is it?"

"Who taught you the two-point method of epidural anesthesia?" Lin Xiaobei asked, this was not just a figment of imagination.

"I checked several related literatures. For some special spinal segments, the double-point method can be used to avoid vital parts."

"Then what do you think is the best way for this patient?" Lin Xiaobei asked tentatively, to see if Liu Xu could make the best choice.

Generally speaking, for patients with complicated conditions, a single anesthesia method is not suitable, but compound anesthesia should be used.Because every kind of anesthesia has advantages and disadvantages, it is necessary to maximize the advantages and avoid the disadvantages.

"I think general anesthesia is preferred, but it's never your first choice."

"why?"

"General anesthesia can ensure the stability of the patient during the operation, but there are too many complications that may occur after the operation, which is difficult to predict, especially the delay in postoperative recovery is very likely to be transferred to the ICU. If this grandfather is transferred to the ICU after the operation, then I think There is no challenge for you at all, anyone can do it."

"You're flattering me too much. I've actually considered general anesthesia."

"Huh?" Liu Xu was a little surprised.

Lin Xiaobei explained: "Your analysis is all right, but there are still some problems that you haven't considered thoroughly. This old man is definitely not good enough for general anesthesia alone, but epidural anesthesia alone is not enough. Because his spinal tuberculosis segment is special, Therefore, it is difficult to determine whether the effect of the epidural can meet the needs of the operation. In addition, this old man has severe bedsores and is usually used to lying on his side. If he lies flat for a long time during the operation, he may not be able to bear it."

"Then what are you going to do?"

"General anesthesia + epidural anesthesia + target blockade."

"Target block?" Liu Xu became curious again.

"Yes, do you still remember the old chest doctor I took you to do? The paravertebral nerve block I performed at that time was actually a type of target block."

"But, why does this old man need targeted injections when he can get epidurals? Besides, he has a lot of bed sores on his back, which are seriously infected, so he's not suitable for subcutaneous injections, right?" Liu Xu questioned.

Lin Xiaobei smiled and said, "I didn't say I was going to do a paravertebral block on the back. I was going to give him a fascial injection of the rectus abdominis."

"Rectus fascia injection?"

"You go back at night and check the relevant literature carefully. This is an old technology with a new use."

"it is good."

Lin Xiaobei suddenly yawned, and despite being covered by a mask, Liu Xu still found it.

"Ms. Lin, would you like to drink some water?" she suggested.

"No, I feel okay, not too sleepy."

Originally very sleepy, but chatting with Liu Xu for a while, Lin Xiaobei felt very energetic.At this time, the patient's vital signs are normal and stable, and the surgical trauma on the stage is not serious, so it is most likely to tempt the anesthesiologist to doze off.

There are two kinds of students who like to doze off in class, one is the students who have no intention of studying, and the other is the students who like to learn, but feel that the teacher's speech is boring and unattractive.

Anesthesiologists belong to the latter category. The patient has no potential safety hazard of changes in vital signs, and the anesthesia effect is just right. At this time, the mental attention cannot be fully concentrated and it is easy to be distracted.

Therefore, many anesthesiologists have the habit of going out to drink water and go to the toilet during the operation, which is actually a self-regulating way to relieve fatigue.

Although Lin Xiaobei looked tired at this time, he was full of energy and his eyes were piercing, like a panda A Bao with a unique skill, which was extremely incongruous with the dark circles around his eyes.

He was secretly wondering, when there was a sudden "ding", [System prompt: Consume an energy potion].

　I got off work last night to catch up on the manuscript overnight, otherwise it will be interrupted today.

　　Idiots are not full-time, and being able to write depends entirely on hobbies.

　　I hope everyone will support you a lot, don't be stingy with the tickets in your hands, please feel free to throw them over, the skin of the idiot is very thick, it can't be hurt. ^_^^_^^_^
　　 Thanks to book friends such as Fireworks and Cold, Sakura, 2019***0535 for their recommendation tickets.

　　Thank you for your continued support!
　　bow! ! !

　　


(End of this chapter)