Seeing Zhao Heng's solemn face, Xiaohong and his wife's mood also began to be worried.

The couple looked at Zhao Heng blankly, for fear that they couldn't anesthetize something from his mouth.

"Doctor. . . I.. Can my daughter-in-law be anesthetized in this situation? ”

Xiaohong's husband stammered and asked very nervously.

"It is possible to have anesthesia, but we need to develop a well-developed anesthesia protocol, which will take time."

Zhao Heng thought for a moment and said slowly.

There are many difficulties in completing anesthesia for this super mother.

First, due to excessive obesity, the patient's blood pressure is very high, and the heart load is also very large, and according to Zhao Heng's observation, even in the resting state, the patient's breathing is not smooth.

This determines that in preoperative anesthesia, muscle relaxants should not be used too much, otherwise the patient's breathing will be suppressed.

Second, there is the problem of puncture.

According to Zhao Heng's visual inspection just now, the thickness of the fat layer on the patient's back must have exceeded that of the puncture needle.

The fat thickness of the average person is 4-5cm, and the fat thickness of the obese person is 6-7cm, but the fat thickness of this super mother is at least 10cm, while the length of the ordinary anesthetic needle is only 8.5cm.

In this case, not only is it difficult to find the location of the puncture, but there is also a high risk that the fat layer is too thick, and the puncture needle will not be able to penetrate the fat and enter the epidural space.

"Thank you, thank you, doctor."

When Xiaohong and his wife heard Zhao Heng say that they could be anesthetized, they immediately felt like they had been pardoned, and said very excitedly.

This child embodies the hope of the couple for a lifetime.

"Recuperate."

Zhao Heng nodded and said.

The excitement of the couple was naturally seen by him.

Soon, Zhao Heng and He Wei left the ward and returned to the office.

He Wei poured a glass of water for Zhao Heng, and then said slowly: "Actually, when this woman came at the beginning, we didn't recommend her to give birth. Originally, she was so obese, the burden on her heart was heavy, and during childbirth, it was very likely to cause heart disease. But the couple was so persistent that I thought of having a consultation with Dr. Zhao. ”

"In this patient's case, it is extremely difficult to get pregnant, and it is not surprising that the reason for such persistence is actually not surprising."

Zhao Heng took a sip of water, nodded and said.

"Yes, it is very likely, so to speak, that it is the only time in the patient's life that she has become pregnant."

He Wei said approvingly.

"In terms of cesarean section, is it difficult?"

Zhao Heng thought for a moment and asked He Wei.

Being an anesthesiologist is not so simple, and before anesthesia, it is necessary to have a comprehensive understanding of the anesthetized object.

"The fat layer on the patient's body is too thick to cut through, but that's not the biggest challenge. I was worried that the patient's heart would not be able to withstand the load of labor during the operation. ”

He Wei thought for a while and said.

This is also the reason why she asked Zhao Heng to come for consultation, although it is difficult to operate on this super parturient, but as a senior obstetric attending doctor of Dongfang Hospital, He Wei thinks that she can still win this operation.

The most critical issue is the patient's cardiac load and anesthesia during the operation.

"Yes, I have observed that patients have a bit of a hard time breathing at rest, and if they use muscle relaxation during surgery, there is a high probability that they will have apnea at any time. The most critical thing is that the fat layer on the patient's back is too thick, and according to my estimates, it is very likely that it has exceeded the length of the puncture needle. ”

Zhao Heng continued.

"What about Doctor Zhao, this patient's anesthesia?"

He Wei asked with some hesitation.

The difficulty is already here, and the risk is also extremely high, if Zhao Heng does not accept the anesthesia of this patient, it is understandable.

"Anesthesia can be done, but a detailed anesthesia protocol needs to be developed. In the past two days, Dr. He, you have applied for a bedside B-ultrasound instrument from the B-ultrasound room. ”

Zhao Heng thought about it seriously and said his suggestion.

"Bedside ultrasound? Where is this going to be used? Could it be that Dr. Zhao, you have found a solution to the problem that the patient's fat layer is too thick to puncture? ”

Hearing Zhao Heng say this, He Wei asked with some confusion.

"Just had an idea, I'll come back tomorrow when I sort it out."

Zhao Heng opened his mouth and said.

"Well, then I'll trouble Dr. Zhao."

He Wei said very politely.

Soon, Zhao Heng returned from obstetrics to the operating room anesthesiologist's office.

As soon as she entered the office, Xu Manni saw Zhao Heng with a solemn face, and couldn't help asking, "What's wrong with the obstetrics department?" What are the tricky patients? ”

"Well, it's a three-hundred-pound pregnant woman, and she needs to be anesthetized."

Zhao Heng said.

"Huh? Three hundred pounds? ”

Hearing this, Xu Manni and Sun Li's eyes widened.

Three hundred pounds, what is this concept?

Under normal circumstances, in the case of average height, the weight of an adult is generally about 130 to 140 pounds.

These three hundred catties are almost two normal adults.

Being so obese can be imagined as a burden on the heart.

"Yes, the most important thing is that the fat layer on the patient's back, which is visually at least 10cm, is likely to exceed the length of a conventional puncture needle."

Zhao Heng said helplessly.

"This..."

Hearing this, Xu Manni and Sun Li didn't know what to say.

The length of the conventional puncture needle is 8.5cm, which is already taking into account the situation of obese patients, generally, the abdominal fat thickness of normal adults is only 3cm, it is conceivable that the thickness of the back fat layer of this patient is 10cm, what an exaggerated number.

"With such a thick layer of fat, not to mention that conventional puncture needles can't penetrate at all, let's just say that the patient is so fat, and it is difficult to find the body surface signs of the puncture."

Xu Manni frowned and said.

In the case of this super mother, it is almost a blind spot of anesthesia.

If you think about it a little, you will know that not only can you not find the body surface mark, but you can't even penetrate the puncture needle, how can you anesthetize this?!

"In this patient's case, if you have to anesthesia, you can only wear it blindly."

Sun Li said suddenly.

"Blind wear? This technique only exists in legends, okay. ”

Hearing her best friend say this, Xu Manni pursed her lips and said.

The so-called blind puncture is a puncture performed by doctors with their extensive experience when the body surface signs cannot be found.

This requires not only a great deal of experience, but also a deep knowledge of the human anatomy.

Xu Manni has also worked in the operating room for many years, and she has never seen this kind of blind wear that only exists in theory.

"Actually, it's not completely blind, it's a matter of luck. Bedside ultrasound can be used to find out the cavity space on the patient's body that is suitable for puncture, and after noting down this cavity space, puncture can be performed. ”

Zhao Heng thought for a while and said.

"Huh? The human brain is not a computer, and B-ultrasound is not a camera, which is not realistic at all. ”

Xu Manni felt that Zhao Heng's suggestion was a bit unrealistic.

Because the image probed by B-ultrasound is not a very intuitive image, it also needs to be restored in the mind by the doctor in three dimensions.

What's more, even if it is restored, then to note this location, you have to pass through the thick layer of fat and accurately puncture to this position, this kind of difficulty is simply breaking through the sky.

In Xu Manni's impression, no one has ever done such a thing!