super anesthesiologist

Chapter 48 Local anesthetic poisoning
The patient in the next room was screaming.

"It hurts, I hurt, doctor!"

"Be patient! I'm giving you a local anesthetic." Bian Wengang scolded impatiently.

"No, I can't take it, oh, it hurts to death! Doctor, stop! Stop! Stop! Stop! I won't do the operation anymore." The patient screamed incessantly.

"Dr. Lin, come over and take a look." Li Aiguo couldn't listen anymore. Even if the voice came from the next room, it was very permeable.

Entering through the door, Bian Wengang was standing by the operating bed, dangling a 10ml syringe in front of the patient.

"If you cooperate again, the local anesthetic will not hurt. You can't do surgery without local anesthetic. You have such a big hole in your forehead. If you don't treat it, it will not only leave a huge scar, but also cause infection. If there is an intracranial infection But it's troublesome. You know what?"

The patient seemed to understand but half understood, and stopped talking.

"Hey, that's it, don't move, it'll be fine soon. Don't move, don't move, hey, I told you not to move, do you hear me? Why are you grabbing my hand? Hey, nurse, nurse!"

The patient suddenly became extremely irritable and danced with his hands.

Lin Xiaobei hurried forward to help, opened his hand, held it down, and observed.

The patient's eyes were frozen, he was absent-minded, and his facial muscles began to twitch.Cardiac monitoring Heart rate alerts for tachycardia.

Local anesthetic poisoning occurred!
"Yes, don't move, hold on for a while." Bian Wengang was still about to administer a local anesthetic.

"Director Bian, stop!" Lin Xiaobei stopped and pressed the blood pressure button at the same time.

"What are you doing?" Bian Wengang was very annoyed that an amateur doctor dared to speak to him in such an orderly tone.

"How many rounds of anesthesia did you take?" Lin Xiaobei asked back, added 2 mg of militane, and then buckled up the mask to give oxygen.

The patient's teeth are closed at the moment, his complexion has gradually turned black and blue, his SPO2 has dropped to 75% rapidly, and the blood pressure on the monitor shows 195/102mmHg, while his blood pressure was almost stable at 135/78mmHg when he entered the operating room.Heart rate 125 beats/min, rhythm irregular.

"Two Li**in and a half of Luo**in, he has such a big wound that he can't do surgery at all."

The patient weighed more than 160 catties visually, and was young and strong.

The diazepam provided by the emergency department comes in a 5ml tube, and two tubes only contain 200mg. The rheumatoid hormone provided in the emergency department comes in a 0.75ml tube with a concentration of 10%, and half a tube only contains 37.5mg.

The total amount of local anesthetic used by Bian Wengang was indeed within the safe range.

But this patient has already experienced such obvious local anesthetic poisoning, and there is only one reason, the local anesthetic penetrates into the blood vessel through the wound.Lidocaine has little effect and can be pushed through the vein, but ropivacaine can't, it can cause serious arrhythmia and toxicity.

"This patient has suffered from local anesthetic poisoning." Lin Xiaobei said calmly.

Bian Wengang was shocked and couldn't believe it: "You, you're kidding. I calculated it based on a weight of 150 catties, and it is impossible to exceed the weight."

"There is no overdose, but the drug may have penetrated into the blood vessels."

"Impossible, I will smoke before the injection." He is still quibbling.

Lin Xiaobei didn't argue with him, "Look at the patient's expression now, as well as his blood pressure and heart rate."

After he gave oxygen through the mask, the patient's complexion returned to rosy, but his jaw was still closed and his muscles were stiff.ECG monitoring SPO2 has risen to 98%, but blood pressure and heart rate are still high.

Bian Wengang stopped talking, the facts speak louder than words.

"Is the patient okay now?" Director Li Aiguo and Liu Kai also rushed over from another operating room.

It may be that the sudden silence here made them feel abnormal, or it may be that they heard "local anesthetic poisoning" and were worried about an accident.

"Observe first, it doesn't look like a big problem at the moment."

"Then, shall we continue with the operation? The anesthesia is very effective over there." The surgical incision had just been made over there, so Li Aiguo went over with Liu Kai after speaking.

Lin Xiaobei used the mask for a full 20 minutes, feeling that the patient's facial muscles had relaxed.

"Hey! Wake up, do you hear me? Don't sleep, wake up!"

The patient opens his eyes.

"What's your name?"

"Hu Qingwen."

"Do you know where you are now?"

"Hospital."

"Do you know why you're in the hospital?"

"There was a fight."

It turned out that he still remembered that there was a sharp pain, and he probably woke up from the wine.

"Doctor, how is my brother?" He actually still remembered his troubled brother.

"It's about the same as you." Lin Xiaobei told him, "He's injured in the socket of the elbow."

Hu Qingwen blamed himself, "Oh, it's all caused by alcohol."

"Are you still in pain?"

Lin Xiaobei tried it with a sterile cotton swab, and there was no reaction to the area where the anesthetic was applied, which meant it was not painful, but he immediately frowned when he pressed lightly on some areas.

Such an anesthesia effect cannot meet the requirements of surgery.

Lin Xiaobei looked at Bian Wengang, he didn't dare to take local anesthesia even with the syringe.

"Doctor Lin, do you want to switch to general anesthesia?" He asked tentatively.

"No, I'll just give him a few targets."

Hu Qingwen is a patient with a full stomach, and the risk of vomiting and aspiration during induction is extremely high, so general anesthesia should only be considered as a last resort.

There are also great concerns about taking local anesthetics. This patient has already suffered from local anesthetic poisoning. The principle is that local anesthetics can no longer be used.However, Lin Xiaobei thought that Bian Wengang accidentally infiltrated Luo Yin into the blood vessels, not because the local anesthetic itself exceeded the standard.

He just needs to ensure that the target injection does not enter the blood vessel.

Maybe Lin Xiaobei didn't dare to do this before.But now he is different, he is a person with a system and special training in a secret room, he is an anesthesiologist who has been comprehensively evaluated by the system and has already started, this skill is not difficult for him at all.

As soon as Bian Wen got up and got out of the way, Lin Xiaobei used a syringe to draw 100mg of roxin and 37.5mg of roxin, diluted it with saline to 20ml, and asked the nurse to take out a scalp needle for children.

Hu Qingwen saw him crying with a needle in his hand: "Are you going to get an injection again? Doctor, can you switch to general anesthesia?"

"Can you see it clearly before talking? Are you afraid of such a small needle? This is specially used for injections for children. Even if children are not afraid, you are still afraid?" Lin Xiaobei picked up the small needle and shook it in front of him.

The needle was as thin as a hair and short.

After reading it, Hu Qingwen calmed down a lot, and murmured: "Then take it easy, it hurts a lot when I got local anesthesia just now."

"Well, as long as you cooperate and don't move around, I guarantee you won't feel any pain."

Lin Xiaobei fixed a few target spots around the wound, and the injection was completed shortly after the drape was disinfected. Except for Hu Qingwen frowned when the needle was pricked, he didn't say a word during the whole process.

After the injection, Lin Xiaobei rolled each target point towards the wound area with a cotton swab, and tried the operation area by the way: "Does it hurt here?"

"It's better than before, but still a little bit."

Patients usually say this to mean that there is no pain, because of psychological effects, they will never admit that they have no pain at all.

The best way at this time is to put him to sleep with some sedatives.

Lin Xiaobei continued to use 2 mg of micrilone, and after a while Hu Qingwen snored like thunder.

"Ding"! [Precise target injection +10, emergency airway management skills +10, vital signs monitoring: +5; reward 1 energy potion, 2 gold bracelets].

The system is rewarding, so there is no need to doubt the effect of anesthesia.

"You can start now, Director Bian." Lin Xiaobei said confidently.

　Dear friends, please support me and help the idiot get through this difficult week.Thanks!
　　
　
(End of this chapter)