super anesthesiologist

Chapter 5 Anesthesiology Brief Science
Monday morning.

After the shift was over, director Lin Chaobing said to everyone: "Please stay with the following doctors." He called out a few names: Zhou Wei, Zhang Nan, Zheng Shugao, Peng Si, Xu Chaoqing, Lin Xiaobei.

"This group of graduate students will enter the department and start to receive clinical training. Now I entrust it to the teaching teachers. I hope that strict requirements will enable them to complete the course smoothly."

Only then did Lin Xiaobei notice a row of immature and unfamiliar faces, four men and two women.Like all newcomers, these Gui Peisheng, who are about to officially enter the clinic, are full of curiosity and longing for the future life, and their eyes can't wait.

"Next, teachers, please choose numbers." Director Lin Chaobing wrote 6 numbers, crumpled them into paper balls, and asked Lin Xiaobei and his teachers to choose them.

Two years ago, when a group of graduate students entered the clinic, there was a boy who was very insignificant and showed a domineering and arrogant appearance as soon as he entered the department. At that time, no teacher was willing to accept it.Director Lin Chaobing had no choice but to arrange for a gentle-tempered male tutor, He Yunkai.

As a result, there was a fierce conflict between the two in the later clinical work, the boy dropped out of school, and He Yunkai was also punished by the Academic Affairs Office.Because of this, he held a grudge against Director Lin, so he resigned and moved to a provincial doctor.

There will always be some thorns in every class of regular trainees, and they are very unlikable, but they must be assigned teachers.Later, in order to avoid unfairness, Director Lin thought of a compromise method: draw lots, and whoever catches it will be unlucky.

Lin Xiaobei was at the end.

When the fifth paper ball number was displayed, Xu Chaoqing glared at him bitterly.

Before Lin Xiaobei could figure out what was going on, Director Lin Chaobing smiled and said to the most beautiful girl, "Liu Xu, you will be with Teacher Lin, Teacher Lin Xiaobei."

It turns out that the fifth number is a boy with buck teeth, who looks like a rascal rabbit when he smiles.Xu Chaoqing frowned secretly.

The beautiful girl walked up to Lin Xiaobei, bent down and bowed, her voice was like a yellow warbler coming out of the valley: "Mr. Lin, hello, my name is Liu Xu, the willow of the willow leaves, and the cotton catkins. My tutor is Director Lin (Lin Chaobing), from now on Please guide me."

"Hello, hello, everyone will learn from and improve each other in the future." Lin Xiaobei nodded quickly in return.

Such a beautiful girl wants to be with me for three years?Thinking about it makes me feel very happy.

The teachers in front all looked at Lin Xiaobei with envy and hatred, and secretly sighed why God is so short-sighted!They had the priority to draw lots, 1/6, 1/5, 1/4, 1/3, but they all missed the candidate they expected, especially Xu Chaoqing, who didn't even grasp the opportunity to choose one of the two.

Lin Xiaobei proudly led Liu Xu into the operating room.

Today's surgery is internal fixation of several lower limb fractures. The anesthesia operation is not complicated, and simple spinal anesthesia can meet the needs of the surgery.

Before preparing for the anesthesia, Lin Xiaobei wanted to test Liu Xu's basic skills, to see if such a beautiful girl was a vase with nothing but appearances.

"Where did you graduate?" he asked.

"S University School of Medicine, I am exempt from admission." Liu Xu whispered, but couldn't hide her pride.

"Ah!" Lin Xiaobei couldn't help but look at her with admiration.

The full name of "recommended exempt students" is "recommend outstanding fresh undergraduate graduates to study for master's degree without examination", which refers to a situation where you can directly study for graduate school without taking the graduate entrance qualification examination, commonly known as "guaranteed graduate students".

Such students must perform very well during college, receive first-class scholarships every semester, and must also obtain various honorary certificates and publish important papers.

Students who can obtain the exemption qualifications among the graduates of key national medical universities like S University must perform extraordinary and outrageously excellent in the undergraduate study stage.

Such students usually have very solid basic skills.

"Why did you choose anesthesiology?" Lin Xiaobei was curious.

The anesthesiology department is a thankless department in the hospital. It is not only responsible for the anesthesia work of the operation department, but also responsible for the first aid work of the whole hospital, and the salary is not high.

There is another department that suffers from a difficult situation is the Department of Pediatrics.

The only advantage is that it is easy to find a job after graduation, because at present, these two jobs in the national medical industry are most short of talents.

It shouldn't be difficult for Liu Xu to choose other majors to find a job. She is so beautiful, and she was exempted from her job by S, even the director of the admissions department would not be ruthless enough to dismiss her.

"I like it." The little girl said briskly, "I think anesthesia is very magical."

"What magic?" Lin Xiaobei laughed to himself, what's the use of magic?It's not just a job to earn money to support the family.

"I was very afraid of pain when I was a child. After studying medicine, I heard that anesthesia can make people lose the pain sensation, so I was very interested."

"Just out of interest?" Lin Xiaobei couldn't help laughing, "How much do you know about anesthesia?"

Liu Xu said with a serious expression: "Anaesthesiology is a science that studies how to eliminate surgical pain, ensure patient safety, and create favorable conditions for surgery."

Sure enough, he is a top student, and he speaks professional terms when he speaks.

Lin Xiaobei was about to start anesthesia, and continued to test Liu Xu, "What anesthesia do you think I should give this patient?"

After asking, he felt a little abrupt. For a medical student who has never been in clinical practice, asking this kind of question is too professional.

"Should it be an epidural?"

Lin Xiaobei stared into her eyes: "Do you know about epidural anesthesia?"

"Understand a little bit." Liu Xu lowered her head in embarrassment, and her voice was like a mosquito, "Epidural anesthesia is to inject local anesthetic into the epidural space, block the spinal nerve roots, and temporarily paralyze the innervated area, also known as epidural anesthesia. Block. Suitable for operations on the abdomen and below, including urology, obstetrics, and lower extremity operations."

"You're right, but I chose spinal anesthesia for this operation. Have you heard of spinal anesthesia?"

Spinal anesthesia is an improved spinal anesthesia method based on the epidural anesthesia method, also known as "subarachnoid block anesthesia", which is to inject local anesthetic directly into the subarachnoid space and act on the spinal nerve root The method of producing anesthesia in the corresponding part is commonly called spinal anesthesia.

Essentially the same principle as epidural anesthesia, the difference is that the local anesthetic is injected into different parts.Spinal anesthesia is a local anesthetic that acts directly on the spinal nerve root, while epidural anesthesia works when the local anesthetic slowly penetrates from the epidural space to the spinal nerve root.

A vivid example is that the pool stores water, and the spinal anesthesia is to put the water pipe directly into the pool; while the epidural anesthesia pool has no water pipe, and needs to be slowly filled with water through the ditch.

Therefore, compared with epidural anesthesia, spinal anesthesia has a shorter onset time and more accurate effect.But because of the closer proximity to several spinal nerve roots, the risk is also greater.

What Liu Xu said is roughly the same. Spinal anesthesia and epidural anesthesia are collectively referred to as spinal anesthesia.

"Besides spinal anesthesia and epidural anesthesia, what other methods of anesthesia do you know?" Lin Xiaobei felt troubled and troubled about bringing such a student.

It was hard to ask a question that she didn't know the answer to.

"Well, it's mainly general anesthesia and nerve block anesthesia?"

General anesthesia, referred to as general anesthesia, refers to the inhalation of anesthetics through the respiratory tract, intravenous or intramuscular injection into the body, resulting in temporary depression of the central nervous system.Clinical manifestations include loss of consciousness, loss of generalized pain sensation, amnesia, reflex depression, and skeletal muscle relaxation.

More than 1700 years ago, Hua Tuo had already used "Mabosan" to give patients general anesthesia for abdominal surgery, and it is said that he was planning to perform craniotomy on Cao Cao.

Nerve block anesthesia refers to the injection of local anesthetic near the peripheral nerve trunk to anesthetize the area innervated by the nerve by blocking the conduction of nerve impulses.

The essence of acupuncture and moxibustion in ancient China is also a method of nerve block anesthesia.

All anesthesia methods temporarily inhibit human body functions and are reversible.It slowly returned to normal after a period of time after stopping the supplementary medicine.

"Classmate Liu Xu, you are so solid, it's very stressful for me to lead you!" Lin Xiaobei joked.It will be easy to take care of such students in the future.

"Mr. Lin, don't be joking. I just read it from the book. In practice, I don't know anything."

"Take your time, don't rush. Today you will watch me get spinal anesthesia first, and pay attention to my operation procedures. By the way, are you familiar with the anatomy of epidural anesthesia?"

"Skin, subcutaneous fascial tissue, supraspinous ligament, interspinous ligament, ligamentum flavum, and epidural space. You need to penetrate a layer of dura mater to reach the subarachnoid space when you receive spinal anesthesia."

This girl knows almost everything.

"Mr. Lin, did you choose the 3/4 of the lumbar (the third and fourth lumbar intervertebral space) for the puncture?" She asked while staring at Lin Xiaobei's position on the patient's back.

"Yes."

The adult spinal cord terminates at the lumbar 1 spine (connected below by the filum terminale), while in children it is below lumbar 3. Therefore, adults usually choose lumbar 3/4 puncture for spinal anesthesia, while children mostly choose sacral anesthesia (which falls under the category of epidural anesthesia). , of course, there are also bold people who choose waist 4/5 for spinal anesthesia in children.

Lin Xiaobei was proficient in his technique and his movements were smooth. After a while, clear cerebrospinal fluid leaked from the tail of the lumbar needle.

Liu Xu's eyes lit up on one side, seeing such a miraculous phenomenon for the first time.

"The local anesthetics used for spinal anesthesia are generally bupivacaine or ropivacaine. In order to consolidate the anesthesia plane for lower extremity spinal anesthesia, 10% glucose is usually added to the local anesthetic."

As soon as Lin Xiaobei finished speaking, there was a sudden "ding" in his mind, and the panel prompted: [Intraspinal anesthesia operation +1].

This……

Not even rewards!

Just when Lin Xiaobei was disappointed, the panel suddenly flashed: [Super anesthesiologist training system prompt: The host accepts a new task: super pregnant woman challenge]!
　(Seek support, ask for recommendation, ask for collection!)

　　


(End of this chapter)