super anesthesiologist

Chapter 43 can be sent back to the ward (please collect, please recommend, thank you!!!)

Lin Xiaobei and Liu Xu were startled at the same time.

Liu Xu was about to speak, but Lin Xiaobei stopped him with his eyes.

He was afraid that she would honestly say that no muscle relaxant was used at all.

"Director Hu, do you think the muscle relaxation is not enough?" He asked back.

"That's enough, I just asked you because I felt too relaxed." Hu Wenmao said in a hurry, afraid that Lin Xiaobei would continue to add muscle relaxants.

In his heart, the smooth operation is the first priority, and the patient's safe return to the ward after the operation is the second.

Now the first priority is in sight.

After the choledochoscope goes down, the incarcerated stones are crushed with grasping forceps, and then flushed with negative pressure to suck out the broken stones.

After the common bile duct is unobstructed, stones in the intrahepatic bile duct become easier, and the liver does not need to be cut.

His mood also became joyful, and a smile involuntarily filled his face.

"That's fine." Lin Xiaobei also laughed.

In fact, he just gave the patient target-controlled pumping of propanol and inhalation of seven injections.Propaminophen is an ultra-short-acting anesthetic, and its effect almost disappears after a few minutes of stopping the drug, while Qi** is excreted through lung breathing, so it is easier to wake up.

"Go check your blood."

Lin Xiaobei told Liu Xu that running errands is a must for Gui Peisheng.She has gained a lot today, and the arteriovenous puncture is all done by herself. This kind of beautiful feeling is indescribable, and it can only be understood and cannot be expressed in words.

Print out the result in a moment.

血糖 12.6mmol/L，pH 7.38（正常值7.35-7.45），PO2：125mmHg（正常60～90mmHg），PCO2：38mmHg（正常值35～45mmHg），Hb 9.2g/L。

Electrolytes are also within normal range.

If there is no accident, the old man can not only wake up, but also wake up very quickly and thoroughly.

When Hu Wenmao started sewing, Lin Xiaobei asked, "Director Hu, how long do you expect to finish sewing?"

If he said within 10 minutes, then all general anesthesia drugs, including the pumped propanol and the inhaled heptachlor, can be stopped now.

If he said within 20 minutes, then slowly reduce all the general anesthetics now, and reduce them to zero when the operation is completed.

Neither of these withdrawal methods would have adverse effects on the procedure, and both would be able to complete the same in the patient's body at the end of the procedure.

"Within 5 minutes, you can stop taking the medicine now." Hu Wenmao said.

This was out of Lin Xiaobei's surprise.

"You don't do fine stitching anymore?"

"If you don't do it, you're already old, what else should you pay attention to?"

"Oh, good. I'm off."

Director Hu Wenmao is a very particular person, and he likes to strive for perfection in everything. To put it bluntly, he likes to be stubborn.

He has been arguing endlessly with Ran Ran, the director of the anorectal department, over the position of chief director of general surgery.Director Hu focuses on clinical work, devotes himself to researching business, and calls himself "Hu Yidao". Director He Ran has a Ph.D. in the United States, with outstanding scientific research capabilities, and is a top-notch talent handpicked by the president.

The two have their own strengths and weaknesses, and Hu Wenmao is far ahead of him in terms of technology, but now the hospital is focusing on scientific research.

In fact, the whole medical industry is the same, doing a hundred operations is not enough to publish a paper, no matter how good a doctor is without SCI and the National Natural Science Foundation of China, he can only be a coolie.

The two also look down on each other.

In the eyes of Director Hu Wenmao, He Ran is the "Zhao Kuo" of the medical field. He can do nothing but write articles. He is a typical paper talker. His surgeries are all performed by the doctors below and his name is on them.

And He Ran's evaluation of Hu Wenmao is "pedantic". After doing so many operations, he didn't know how to summarize a few high-quality papers.

Hu Wenmao couldn't compare with He Ran in scientific research, so he had to work hard in clinical practice.He pursues perfection in all surgeries, especially the small surgical incisions, so that when the patients return to the ward and wake up, they will feel that he is great when compared with others.

This is also the reason why Lin Xiaobei has been hesitant to extend the incision during the operation.If this operation is done delicately, it only needs to make a small incision within 5cm, and insert a few fingers to complete the operation.

The length of Wang Yuansheng's surgical incision exceeded 10cm.

Because Lin Xiaobei knew his character well, he suggested subcutaneous sutures.The advantage of this suture method is that the skin incisions are well closed, leaving almost no gaps. Unless there are scars, only a faint line can be seen after the incision heals.

This suture is most commonly used on children and young women.

Hu Wenmao used thick thread interrupted sutures, and added rubber rings outside the body to prevent muscle damage due to excessive tension of the sutures.

This suture method is relatively low-tech, and only needs to close the skin together, which is simple and rough.But it is also very trouble-free, and the stitching is completed in a few minutes.

"Old Li, why are you here?"

Hu Wenmao looked up after finishing the last stitch, and saw Li Aiguo, the director of the emergency department, standing at the door.

Lin Xiaobei and the others were all taken aback. They were so focused on the stage that they didn't even notice when Director Li came in.

"I'm here to study." Li Aiguo smiled and walked to the anesthesia table.

"Hi Director Li!" Lin Xiaobei greeted.

Liu Xu didn't know Li Aiguo, but she knew that it was the director of the hospital so-and-so, so she obediently moved the stool for him to sit on.

"No, no, I'm fine standing here."

Li Aiguo stood at the head of the operating table, watching the stage.

At that time, the operation had already been completed, and the last plaster was applied, and Zheng Quan had already begun to remove the drape.

Everyone, including Hu Wenmao himself, thought that Li Aiguo was looking for him.So after getting off the stage, he went straight to Li Aiguo and asked, "Brother, what's the matter?"

"I'm here to see Dr. Lin."

Hu Wenmao and Lin Xiaobei were taken aback at the same time, especially Lin Xiaobei was even more surprised.

He is not familiar with Li Aiguo at all, and has only heard some rumors about him.He was originally the director of the anorectal department, with superb professional skills and a hot temper, but after returning to China, he could not tolerate two tigers. Without scientific research, he was naturally defeated.

The hospital leaders were frightened by his integrity and responsibility, and knew that he would not be willing to be under the influence of others, so they transferred him to the emergency department as the director.

This was all before Lin Xiaobei entered the anesthesiology department.

"What's going on? Director Li?" he asked with a smile.

"Let's talk about it when you're done." Li Aiguo seemed to have a private matter and didn't want to discuss it publicly.

Hu Wenmao made fun of himself, coughed dryly and laughed, and sat on the side to rest, waiting for Lin Xiaobei to wake up the patient.

Since there is no additional roxime ammonium, the amount of induction has been excreted long ago.After stopping the drug, Wang Yuansheng's spontaneous breathing returned quickly, and his tidal volume reached 400ml.

"Can the tube be extubated?" Hu Wenmao couldn't forget that matter, and Wang Yuansheng couldn't let go until he opened his eyes.

"It should be possible." Lin Xiaobei said conservatively.

As soon as he finished speaking, the patient on the bed moved.

"Wang Yuansheng, open your eyes."

"Liuxu, get ready to extubate."

The timing of tracheal extubation is now somewhat controversial in the anesthesia community.

Many experts recommend that the patient be fully awake before pulling it out. This has the advantage of ensuring a smooth airway, but the stimulation of the endotracheal tube is also obvious, which is difficult for many patients to tolerate, so it is easy to cause coughing and laryngospasm.

Lin Xiaobei likes to extubate when the patient breathes spontaneously and can maintain the oxygen supply, which is more stable and minimizes the pain of the patient.Especially in Wang Yuansheng's current situation, severe coughing can instantly increase intra-abdominal pressure, which may cause the wound to rupture.

The two methods have their own advantages. The former focuses on safety and is often used in facial surgery and difficult airways; while the latter is more humane, but must be able to ensure safety.

Hu Wenmao was very happy to see Wang Yuansheng opened his eyes and looked at the ceiling.

"Wang Yuansheng, do you know where you are now?" He asked, patting the patient's shoulder.

"In the hospital." Still vague.

"You are in the operating room now, the operation has been completed, your disease has been cured by us, and you will recover soon."

"The operation is over? Why don't I know?"

"You're all asleep, so you definitely don't know. Do you know who I am now?"

The old man even recognized Hu Wenmao, "You are Director Hu."

"Hey, that's right." Hu Wenmao was very happy.

"Doctor Lin, when will he return to the ward?" He turned to ask Lin Xiaobei.

"Wait for a few more minutes."

Lin Xiaobei probed Wang Yuansheng's lower chest with a needle, "Does it hurt here?"

"No pain."

"What about here?"

"It doesn't hurt either."

"What about here?"

"Oh, a little bit."

……

"You can send it back to the ward, Liu Xu. Help me tidy up."

"Ding"! [Nerve block +10, target precision injection +20, vital signs monitoring +10, application of basic theoretical knowledge +20, improvement of medical ethics and medical style +10; reward 1 energy potion, 2 gold bracelets].

The harvest was good, Lin Xiaobei was secretly happy.

"Dr. Lin, if you have time at noon, let's go have a meal together." Hu Wenmao invited.

Before Lin Xiaobei could speak, Director Li Aiguo, who had been silent all this time, declined on his behalf: "No need, Lao Hu, I have something to do with Dr. Lin, and you can clear it up another day."

Lin Xiaobei: "..."

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(End of this chapter)