super anesthesiologist

Chapter 68 Special intestinal obstruction (please recommend, please collect, thank you!!!)

The smile on Li Aiguo's face stretched immediately, what he was waiting for was Lin Xiaobei's words.

As if he was afraid that Lin Xiaobei would go back on his word, he said hastily, "Okay, we will prepare for the operation right away."

"Director Li, you don't need to do sufficient preoperative preparations?"

"This is an emergency surgery, just follow the preoperative preparations for emergency surgery"

Lin Xiaobei immediately entered the operating room to prepare.If there are not multiple operations performed at the same time, the main operating room is generally selected.

After a while, Xu Zhenzhen also came in, preparing surgical instruments.

The old man was wheeled in in an ambulance.

Because the old man is too old and it is inconvenient to communicate, Lin Xiaobei communicated with his family members that he may be transferred to the intensive care unit (ICU) after the operation.

It is impossible to transfer to the anorectal department. On the one hand, they will never accept the remedy. On the other hand, director Li Aiguo has deep opinions on the anorectal department, and will not transfer the patient there unless it is absolutely necessary.

When Lin Xiaobei positioned the old man, Xu Zhenzhen still couldn't help asking: "Doctor Lin, what kind of anesthesia are you planning?"

"Target injection combined with inhaled general anesthesia."

When talking about "general anesthesia", director Li Aiguo glanced at him.

In the emergency department, everyone seems to be very taboo about the word "general anesthesia", and try not to use it as much as possible.

Lin Xiaobei ignored Li Aiguo's doubts, he had his own reasons for making such a choice.

This is in reality, he has to take responsibility, and he must not let go of his hands and feet without any worries like training in a secret room. He wants to leave some escape for himself.

Xu Zhenzhen breathed a sigh of relief when she heard the word "general anesthesia". When she was studying in the anesthesiology department, such operations were not uncommon, and almost all of them were under general anesthesia.

Lin Xiaobei watched with gusto while he was injecting at the target site.

In fact, she can't understand anything. The ultrasound image is like a cloud of doubts to her, except for the intertwined black and white spots, which is completely confusing.

But Lin Xiaobei's movements were clean and neat, not awkward, and that was enough.

This shows that he has a plan in mind.

Xu Zhenzhen sincerely hoped that Lin Xiaobei would do every anesthesia perfectly in the emergency department.

After the target injection, Lin Xiaobei began to test the effect.

What the hell, under the advanced ultrasound guidance in the secret room, his blocking effect was extremely poor, but when he returned to reality, he seemed to have obtained a special ability.

During the acupuncture, Xu Zhenzhen turned her eyes away and couldn't bear to look directly, worried about hearing the old man yelling.It is too common in the anesthesia department for local anesthesia.

However, the old man didn't respond at all, even the whining before entering the room stopped, and he closed his eyes as if he was resting.

"We're ready to start the surgery," Lin Xiaobei said.

"Okay." Director Li Aiguo immediately went to the sink.

Xu Zhenzhen couldn't believe it, "Doctor Lin, you don't have general anesthesia anymore?"

Although Lin Xiaobei's local anesthesia works very well, it seems a bit far-fetched that local anesthesia alone can complete intestinal obstruction surgery.

"Let's see the effect first."

Lin Xiaobei didn't rely entirely on targeted injections. He also used a little intravenous analgesic and 1mg of milidine. He didn't have an endotracheal tube or a laryngeal mask, just a nasal cannula for oxygen.

The old man quickly fell asleep on stage.

Li Aiguo disinfected the poison on the stage, tried it with tweezers, and asked Lin Xiaobei: "Can I start?"

Lin Xiaobei indicated OK with gestures.

He has a question, this kind of operation requires at least two people, the chief surgeon and an assistant.Can Director Li Aiguo do it alone?
I don't know where Director Bian Wengang has gone. For him, such an operation is a very good opportunity to improve his skills.

But Director Li Aiguo didn't say anything, and seemed confident that he could do it alone.

When cutting the skin, Lin Xiaobei paid special attention to the old man. If he blinked and frowned at this time, it was time to consider using general anesthesia.Fortunately, the old man is in a paradise, and everything on stage has nothing to do with him.

He slept so soundly, and the data on the ECG monitor seemed to be fixed.

Li Aiguo cast an approving look at Lin Xiaobei.

At this time, Xu Zhenzhen's eyes relaxed, and Chepi did not respond, which proved that the anesthesia effect was indeed in place.

She took a deep look at Lin Xiaobei from the side of the stage, admiring, admiring, and...

The anesthesia worked well, but the surgery didn't go as smoothly as expected.Perhaps Director Li Aiguo was overconfident. When entering the abdominal cavity, he did not pull out the patient's intestines like doctors in the anesthesiology operating room and turn them over for inspection.

He just used his fingers to search the abdominal cavity.

His incision was very small, which was a last resort. If such a large incision was made in the emergency department as in the anesthesiology operating room, the patient would have to stay for at least a week.

The emergency department can only do "day surgery", as the name suggests, they are not allowed to stay for a long time.

But this is intestinal obstruction, not appendicitis.

Director Li Aiguo looked troubled. He moved his fingers back and forth in the patient's abdominal cavity and kept making tut-tut sounds.

To perform this kind of surgery alone, one needs to pull the hook and probe, and the surgical field of view is so small, it is really too busy.

Another point is that the old man is old and has poor skin elasticity. From his angle, it is not easy to pull the hook and expose it.

"Doctor Lin, come and help me."

Finally unable to bear it any longer, he called Lin Xiaobei to the stage.In principle, the assistant doctor should be called.But Li Aiguo felt that it was not appropriate to call an assistant for help in the middle of the operation.

And the door is full of family members of the patients, and calling the doctor in from outside will cause them a lot of psychological pressure.

He prefers to choose Lin Xiaobei.

"Uh."

Lin Xiaobei washed his hands again, changed his isolation gown, and put on gloves.

After he took the stage, Li Aiguo freed up one hand, and felt a lot more relaxed.

However, this old man's situation is far more complicated than imagined.

What Li Aiguo initially diagnosed was adhesive intestinal obstruction, which might be caused by appendicitis.But looking down from the incision, it was found that the intestinal wall at the base of the appendix was smooth and could easily shift.

His first feeling was that there was a misdiagnosis.

This kind of misdiagnosis is not uncommon in clinical practice, and there are too many diseases that cannot be completely correctly diagnosed by medicine.Therefore, many doctors, including famous experts, will put a "?" after the diagnosis, just in case.

The most important thing at this time is to find out the cause of the obstruction.

Li Aiguo explored it with his fingers for a long time without any results, he was a little anxious, and his expression became more serious.

"Director Li, take a break and let me take a look?" Lin Xiaobei persuaded gently.

This is a delaying tactic.Sometimes the operation does not go well, so don't act recklessly, blindly eager for success will be counterproductive.

When encountering this kind of embarrassment in clinical practice, usually the chief surgeon will temporarily put down the work in hand, or sit on the edge of the table to rest for a while, or cover the wound area without moving, and even some doctors simply ask an assistant to protect the wound and step down by themselves Go out for a smoke and relax for a while.

Li Aiguo listened to Lin Xiaobei's opinion, temporarily handed him the tweezers and intestinal forceps, and sat aside to rest.

Lin Xiaobei began to pretend to be curious, then put his fingers in, and slowly groped along the intestine.

The training in the secret room provided him with a lot of valuable experience, and his technique was more gentle and delicate than Director Li Aiguo.

After a while his hand withdrew from the surgical incision and brought out a section of intestinal wall.

Director Li Aiguo's eyes opened like copper bells.

Lin Xiaobei didn't completely pull out his intestines, the surgical incision was too small to accommodate it.

But Director Li Aiguo could see clearly that the two sections of intestinal wall he had drawn were indeed partly glued together.

"Director Li, I think the surgical incision should be enlarged." Lin Xiaobei suggested.

Too small, even if the obstruction is found, it cannot be operated.

"Okay, don't move, I'll do it." Li Aiguo said excitedly, picked up the scalpel, put the back of the knife against Lin Xiaobei's finger, and slowly opened the wound forward.

His movements are very delicate, and he stops every time he draws a little length to see if it is enough.It's not like Bian Wengang's one-size-fits-all approach.

About two fingers away, he stopped.Lin Xiaobei tried, just enough to pull out a bowel tube.

Under the effect of pulling, the two sticky intestines separated, and one of them slid back into the abdominal cavity.

The obstruction was relieved, but the cause of the obstruction was not found.

At this time, the patient's intestines can be slowly pulled out of the abdominal cavity like a routine operation, and examined section by section.But this kind of operation is too rough, the effect of target injection cannot meet the requirements of the operation, and the patient can't stand it.

"Call the ultrasound department for a consultation?" Lin Xiaobei suggested.

Director Li Aiguo nodded, and said to Xu Zhenzhen, "Go ask the doctor on duty to call the ultrasound department for emergency consultation."

　Thank you all for your perseverance!

　　
　
(End of this chapter)