After the scene is set up, the next step is to anesthetize the patient.

An anesthetic is a type of drug, and an overdose of any one can be fatal, as can an anesthetic.

Moreover, in the process of surgery and anesthesia, a comprehensive judgment is made in strict accordance with the patient's kilogram weight, age and individual condition.

Once the judgment is wrong, the overdose of drugs in anesthesia will be artificially caused, which will threaten the life safety of patients.

When anesthesia is performed in clinical practice, there must be a lot of equipment, including monitoring equipment and rescue equipment, etc., which can be detected and treated as soon as possible in case of special circumstances.

Now it's outdoors and there isn't any monitoring equipment at all.

Seeing that Li Xiyang was about to anesthetize the patient, Qian Min and the others secretly pinched a cold sweat.

Anesthesia is definitely not a simple matter, otherwise it would not be separated from such a branch.

In fact, every year around the world, there are cases of death due to too much or too little anesthesia.

Qian Min remembered that Renhe had a death from anesthesia half a year ago.

The person responsible is also an old anesthesiologist who specializes in manipulation.

At that time, it was a woman who requested epidural analgesia during labor.

After the epidural catheter was inserted, 4 ml of 0.25% bupivacaine was injected as a test volume, and the results showed that within 2-3 minutes the patient developed a block of the sensory and motor nerves at a high level.

The withdrawal of the epidural catheter showed clear fluid outflow, and a positive sugar test confirmed catheter placement in the subarachnoid space.

The anesthesiologist had to switch to subarachnoid anesthesia for labor analgesia and give a bolus dose of bupivacaine.

According to the chief surgeon and assistant doctor at the time, the scene effect was good.

But halfway through the operation, the pregnant woman suddenly had difficulty breathing and lost consciousness.

The patient then suffered cardiac arrest and was quickly resuscitated, but died after resuscitation.

The final result was that the anesthesiologist overdosed.

This kind of incident has always been common.

Off-the-shelf amputation is performed outdoors under anesthesia, and the amount of drug in it is more difficult to control precisely.

can look at Li Xiyang again, as calm as ever.

After inquiring about the patient's height and weight, Li Xiyang quickly dispensed the medicine.

"Syringe 10% lidocaine saline diluted 1:1."

Hearing the drug ratio, Qian Min exclaimed, "Doctor Li, are you going to give the patient a local anesthetic?" ”

Hearing this, the person in charge on the side and the rescue personnel of the fire brigade were all shocked.

If you have a local anesthesia for such a big operation as amputation, it won't hurt to death?

Li Xiyang shook his head and smiled.

Hospitals do limb amputation surgery, usually choose general anesthesia, so that the patient is in a deep sleep and does not feel pain during the operation.

This is easy for people to understand.

However, if local anesthesia is chosen, will the patient be in pain during the operation?

Will it hurt to death, as some fear?

In fact, in terms of pain, local anesthesia is almost identical to general anesthesia.

When a nerve in an area of the body is temporarily blocked, pain signals cannot be transmitted to the spinal cord and brain through the nerve endings, and pain is not felt in the mind.

Here, a more vivid analogy can be quoted, the nervous system is like a telephone system, the brain is the switchboard, the nerves are the telephone lines, and the painful parts of the body are the telephones.

General anesthesia mainly acts on the brain, and local anesthesia mainly acts on telephone lines.

The methods and approaches are different, but the result is the same,

In the end, it is all about achieving the goal of "painless" surgery.

So for amputation, is it better to choose general anesthesia or local anesthesia?

From a medical point of view, comparisons cannot be made in general.

It should be said that both options have their pros and cons!

Determined by various factors such as the method of surgery and the patient's physical condition, the doctors will strictly check and choose the surgical plan that suits the patient's physique and condition as much as possible.

For the current patient, the reason why Li Xiyang chose local anesthesia is because of the tight time, and the other most important reason is that the patient is very likely to have impaired cardiac function, and in this case, the patient is likely to die of anesthesia with general anesthesia.

Especially now that the monitoring equipment is missing, Li Xiyang is even more unlikely to risk giving general anesthesia.

In fact, many hospital amputations are now performed under local anesthesia.

In many cases, the patient asks for general anesthesia because he is worried about the pain and because he is afraid of seeing the surgical scene.

To put it bluntly, these are just the psychological effects of the patient.

Hearing this, everyone nodded suddenly.

scratched their heads and laughed one by one, and they almost made a joke.

But Qian Min on the side was not at ease, of course she knew that local anesthesia amputation was nothing new in clinical practice.

Local anesthesia is not simple, it is also a technical job.

The usual thing is to inject a few injections into the surgical area,

The innervated nerve type tissue that accurately selects the surgical area is also a type of local anesthesia, called neural tissue, which is actually a higher level of local anesthesia.

She heard Dong Hua say that if the former is compared to a cannon firing indiscriminately at the enemy's position, then the latter is a precision-guided missile.

What Li Xiyang is going to do now is to block anesthesia of the right orthopedic nerve and sciatic nerve.

This kind of anesthesia, even a professional anesthesiologist has to use color ultrasound to locate it.

And Li Xiyang now has to do blind exercises without vision...

Qian Min was really secretly pinching a cold sweat for him.

Soon, the medicine is ready,

Anesthesia begins!

According to the shape of the sciatic nerve, Juding first anesthetized the bone nerve block.

Along the upper thigh, starting from the skin layer by layer, anesthetized,

The needle is carefully inserted when it is inserted into the nerve sheath.

Li Xiyang asked the patient, "Is there an electric shock?" ”

The patient nodded, and the muscles in his face trembled.

Li Xiyang knew that he had reached the position, so he immediately pushed the medicine into the patient's body.

And the pain on the patient's face at this time is disappearing little by little.

"Hey, it doesn't hurt anymore!"

The patient was pleasantly surprised.

The sharp pain just now penetrated deep into the bone marrow, and it was wearing down his will and spirit all the time.

All of a sudden, the pain disappeared, and he became excited.

Li Xiyang turned around and nodded at Qian Min, "The anesthesia is successful, and the operation is ready!" ”

Qian Min looked at Li Xiyang deeply, this person seems to be omnipotent, there is nothing he can't do...

"Little money!"

"Oh, okay!"

Coming back to his senses, Qian Min hurried to get the surgical bag.

The emergency center came with the help of the doctor on board, and soon the equipment was displayed one by one.

Main items: surgical gown, abdominal sheet, orthopedic dressing kit, orthopedic instruments, wire saw and hook, gloves, 23# blade, suction device, high-frequency electric knife, ordinary No. 1, 4, 7 silk thread, Vicho thread...

Spare items: drainage tubes, drainage bags, electric tourniquets, surgical patches, bone wax...

Even outdoors, disinfection and infection prevention measures are still not evived.

"Small money, regular disinfection, towel!"

"Yes!"

Hand sterilization trays, sterilizers, iodophor gauze...

Shop order order: large single four-layer → small single → cloth towel pliers fixed → medium single...

Cut open the skin to reveal the superficial layer.

Alcohol cotton balls disinfect the edge of the incision again...

Fix and connect the electric knife and suction device, gauze to wipe the blood...

Hand 23# knife to cut the skin, and then use an electric knife to cut layer by layer...

Hands in the middle of the curved pliers free...

23# knife incision, retractor retractor to retract vastus lateralis, expose periosteum...

In the plane of muscle retraction, circumcision of the periosteum...

Deliver periosteal ionization, push away the distal periosteum...

Hand to = wire saw and two retractors to break the femur ...

Bone frustration and smoothing of the stump...

Hand 4# silk thread ligation stump blood vessels...

Hand saline to rinse the wound, alcohol to disinfect the skin...

Hand absorbable threads to suture muscles and fascia...

Disinfect the skin with alcohol again, and suture the wound intermittently...

Alcohol gauze covers the wound, bandages with moderate force...

Li Xiyang's movements were very fast, and the bleeding was also very fast.

Everyone felt that it had only been a while, and the amputation had been completed?!

Li Xiyang put down the extra bandages and gauze and motioned for the firefighters to carry the patient onto the stretcher.

The emergency personnel ran to the front to drive, and Li Xiyang and Qian Min quickly packed up the surgical instruments on the spot.

After packing up, the two also hurriedly ran to the ambulance.

Everyone got into the car, and the driver stepped on the accelerator as soon as possible.

The car started and immediately rushed towards Renhe Hospital.

The anesthetic injected by Li Xiyang into the patient lasted for 2 hours, and now the anesthesia is not over, and the patient still does not feel pain.

However, once the anesthesia is over, the patient will definitely suffer from pain in the bone marrow.

At present, only the amputation has been completed, and the patient's hepatosplenic hemorrhage has not been treated.

Therefore, it is necessary to rush back to Renhe operating room before the anesthetic is gone.

In the car, Li Xiyang checked the patient's vital data again, the heart rate had risen to 125 beats per minute, and the blood pressure had dropped to 80/40mmHg.

The blood oxygen is barely maintained at 70% by oxygen inhalation.

The patient's condition is very dangerous and he is in dire need of a blood transfusion.

The ambulance lacks equipment and can only be rehydrated to maintain the patient's oxygen delivery.

Blood transfusions can only be done at the hospital.

"Master driver, hurry up!"

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