Next.

Eight twenty.

Inside the office of the Department of Anesthesiology.

As soon as Zhao Heng entered the office, he picked up the schedule on the table and looked at it.

Today is the general class, which means that the firefighters will go to support wherever there is a problem.

In general, only more experienced doctors are competent.

Speaking of which, during this time, Zhao Heng worked most of the time, and only had a few surgical anesthesia fixed schedules every day, and the rest of the time was used to go to various departments for consultation.

At this moment, nurse Tian Zhen walked in and said to Zhao Heng: "Doctor Zhao, there is a consultation in the oncology department, let you go." ”

"Oncology? Well, I see. ”

Zhao Heng was a little puzzled, this oncology consultation was still relatively rare, but he still nodded.

This nurse Tian Zhen, speaking of which is a nurse in the anesthesiology department who is responsible for coordinating consultations, this kind of work is actually the envy of many nurses.

After a while, Zhao Heng came to the oncology department.

As soon as he entered the doctor's office, Zhao Heng obviously found that the atmosphere of the oncology department was completely different from other departments.

How so?

There is a very solemn feeling, probably because many of the patients in the oncology department are cancer patients who are dying.

As soon as he came in, Li Haiyang, the attending doctor of the oncology department, stood up, greeted Zhao Heng and said, "Doctor Zhao, you can be regarded as here." ”

"Hmm."

Zhao Heng nodded.

However, when Li Haiyang said this, Zhao Heng would often hear it recently.

"I asked Dr. Zhao for consultation today, because we have a patient with advanced liver cancer who needs neuraxial analgesia."

The attending doctor Li Haiyang said straight to the point.

"Do you want neuraxial analgesia?"

Hearing Li Haiyang say this, Zhao Heng was a little surprised.

Here, we have to talk about the treatment of pain in the advanced stage of cancer, as we all know, in the advanced stage of cancer, the patient's pain will increase day by day.

At first, oral analgesics can suppress the pain, followed by plexus destruction, and finally, if the pain cannot be suppressed by plexus destruction, an endoneurial analgesic device must be implanted by an anesthesiologist.

It can be said that the implantation of neuraxial analgesic devices is the last resort.

In fact, the scope of application of anesthesia is far beyond the general understanding, and it can not only be applied to surgery.

Among them, the reason why pain treatment is relatively little known is that once the pain treatment requires the intervention of an anesthesiologist, it is generally the pain of advanced cancer.

"Yes, I have done celiac plexus destruction for this patient twice before, but the pain symptom relief is still not obvious, no, now I am afraid that I can only do neuraxial analgesia."

Li Haiyang sighed and said.

As a doctor in the oncology department, Li Haiyang feels that every day of work is very depressing.

If you think about it, most of the patients you face every day are terminally ill and have a short life.

For many patients with advanced cancer, the main treatment is actually analgesia.

...."The patient's situation is complicated? ”

Zhao Heng thought for a while and asked.

If the situation wasn't complicated, I guess he wouldn't have been invited.

This neuraxial analgesia is actually to give analgesics directly to the spinal canal of the spine, which is similar to clinical puncture anesthesia, and can be done by ordinary anesthesiologists.

"The patient's crest tumor mass invaded most of the lumbar vertebrae, and it was very difficult to puncture."

Li Haiyang said slowly.

"Has it spread to the spine?"

Hearing Li Haiyang's words, Zhao Heng was a little surprised, as we all know, in advanced cancer, cancer cells will spread to the whole body, and the wider the spread, the shorter the patient's remaining life expectancy.

This has spread to the spine, which means that the patient has not been around for a few months.

"Yes."

Li Haiyang nodded heavily, this kind of heaviness is something that every doctor will experience and experience every day in the oncology department.

"What do the families of the patients say?"

Zhao Heng asked again.

This neuraxial analgesia treatment does not mean that it will be effective for a long time if it is completed at one time.

For the patient Li Haiyang said, he couldn't even suppress opioids because of the pain before, and he had already done nerve destruction surgery, and now neuraxial analgesia is the last resort.

Neuraxial analgesia is rarely used as a last resort for pain relief in cancer patients, not because the treatment is not effective, but because it is expensive.

An intraaxial analgesic device, with a silicone catheter at one end, is punctured and implanted into the subarachnoid space, exits the spinal canal, is immobilized, and then travels under the skin.

The catheter is connected to a programmable computer pump under the skin of the abdomen, and the drug infusion mode is set according to the patient's pain characteristics, so as to deliver morphine directly to the brain crest fluid to achieve the purpose of efficient use of morphine.

Not to mention, this programmable computer pump implanted under the skin of the patient's abdomen is very expensive and can only be imported.

"The family agreed, but the patient himself was unwilling to do the treatment."

Li Haiyang sighed and said.

In the treatment of advanced cancer, there are many times when there is a dilemma.

The most important thing is the moral dilemma.

As we all know, many patients with advanced cancer cannot be cured, and their remaining life is limited.

And in a limited time, the level of treatment that should be carried out has gradually evolved from a medical problem to a moral dilemma.

For many families of terminal cancer patients, there will be a situation of "both people and money".

"The patient wants to leave some money for his family."

As soon as Zhao Heng heard it, he knew that this must be the case, because such a thing had happened countless times in the hospital.

"Yes, many patients in our department have this idea, and in order to reduce the burden on their families, they are reluctant to continue treatment."

Li Haiyang nodded and said.

"Doctor Zhao, about this matter, the family has already approached me, and the family's intention is to let us say that this treatment is a very normal and ordinary treatment. In this case, the patient will be able to receive the treatment. ”

After a pause, Li Haiyang said with some embarrassment.

"White lies?"

Zhao Heng thought about it and said.

"Yes, the family really can't bear the pain of the patient's advanced liver cancer, but the patient is more stubborn, so he can only take this way."

Li Haiyang said helplessly.

The reason why liver cancer is called the king of cancers is because the pain and torture of patients in the advanced stage of liver cancer is the most severe among all cancers.

How to put it, it was a kind of pain and torture that ordinary people could not imagine.

Statistics show that 60% of patients with advanced liver cancer will have thoughts of suicide within about a month of diagnosis.

The reason for this is because I don't want to face the terrible pain and torture of advanced liver cancer every day.

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