The patient is given an anesthetic injection and local anesthesia is administered. Or anesthetize the patient to the point of coma, which is commonly known as general anesthesia, which is just the most basic and simple job of an anesthesiologist.

The technical content is not high.

Anesthesiologists are truly respected as life guardians because they are able to give patients all kinds of life support.

They can predict various crises in advance, so that the safety of the entire perioperative period is under their control.

During the operation, the patient had allergies, cardiac arrest, respiratory failure, blood pressure plummeted, and blood oxygen dropped badly...... Any vitalith-related problems that patients encounter during surgery, they need to be the first to give a solution.

If the patient is in cardiac arrest, then immediate CPR is necessary.

If ventricular fibrillation occurs, defibrillation must be performed.

It can be seen from this that the anesthesiologist's job is not only anesthesia, but also responsible for the safety of the patient during the operation. They need to do a good job of controlling the patient's vital signs during the operation to ensure that the patient can complete the surgical treatment smoothly and in a painless and safe condition.

If you just administer anesthesia to a patient, you are not called an anesthesiologist, but an anesthesiologist at an aesthetic institution.

Why do medical aesthetic institutions often have accidents? Every now and then someone dies.

Because they only have anesthesiologists, not anesthesiologists.

Many people are stupid and can't tell the difference between anesthesiologists and anesthesiologists, but after such a comparison, they should be able to distinguish the difference between the two.

In the future, if you go to plastic surgery or something, you will not easily put your life in the hands of a fake doctor who only knows how to use anesthetics.

Those anesthesiologists, no matter how tall he is packaged and how bragged he is.

They all belong to technicians, not doctors.

Anesthesiologists in regular hospitals have medical licenses and physician qualification certificates, have the right to prescribe, and can participate in surgery.

Anesthesiologists are much more advanced than anesthesiologists.

Dr. Yu looks to be in his fifties, and every time he undergoes a super difficult fourth-level major surgery, he will be seen. Zhou Can secretly guessed that Dr. Yu was the chief physician nine times out of ten.

He helped Dr. Yu with his work, and he never thought of asking for anything in return.

Unexpectedly, Dr. Yu suddenly taught him some advanced anesthesia knowledge.

It was a bonus.

Zhou Can humbly listened to the anesthesia experience he imparted, and even wrote down some knowledge points in his notebook.

A good memory is better than a bad pen.

Sometimes an operation needs to remember a lot of things, and even what sutures are needed to suture organs and peritoneum, Zhou Can writes them down in his notebook. Surgery is a matter of life and safety, and a small suture can sometimes lead to the failure of the operation.

By no means alarmist.

And even more so without exaggeration.

For example, when suturing some organs or tissues with high tension, thinner sutures are used.

The patient just sneezed after the procedure, but not excessively, right?

Then the stitched area cracked.

If it's a good body surface, you can find it in time and sew it again.

If the surgical wound is cracked in the abdominal cavity or chest cavity, isn't it the end of it?

"Do you know what the patient's illness is?"

Dr. Yu asked.

"Thymoma!"

Zhou Can was ashamed and knew very little about this patient's condition. Because he belongs to Director Xueyan's group, he is only familiar with the patients in this group.

For its group of patients, there is little opportunity to learn about it.

"Before the implementation of anesthesia, it is necessary to link with the patient's disease and physical condition, and comprehensively consider the patient's position and anesthesia plan. For example, this patient has myasthenia gravis and needs to be placed in a supine position and a thin pillow on the back of his shoulders before surgery. For patients with myasthenia gravis, an effective therapeutic dose of anticholinesterase drugs should be developed......"

Although Dr. Yu has a somewhat eccentric personality, the valuable lessons he taught Zhou Can are all dry goods.

Zhou Can studied modestly and picked the key points to record in the notebook.

After the patient was given general anesthesia for endotracheal intubation, it didn't take long for Director Le and Director Hu Kan to come.

Zhou Canna is the one who deserves to insert a urinary catheter for a patient.

I just got it.

Earned another 1 placement experience.

"Doctor Xu, how is the patient?"

Director Hu inquired about the patient's condition and had already started asking the nurse to help him put on sterile gloves.

"Yes, it can be operated."

Dr. Yu really cherishes words like gold.

Even the chief physician who treats the most powerful cardiothoracic surgeon has a cold and indifferent tone, and there is no smile on his face.

I heard that the longer an anesthesiologist works, the more silent he becomes.

Because their nerves are constantly under high tension, the nature of their work does not allow them to make small talk with others.

In this sense, the anesthesiologist is as important as the surgeon.

Anesthesiologists in the United States earn the same annual income as surgeons.

However, in China, anesthesiologists are facing various difficulties. The income is not low, and the basic salary of the attending anesthesiologist plus various performance and overtime pay is about 20,000 yuan. Coupled with the year-end bonus, it can reach more than 30,000.

But they bought it with their lives.

According to statistics, 14 out of 29 doctors who died suddenly were anesthesiologists.

The anesthesiologists who died suddenly were strong young men, up to forty years old.

From this death data, it can be seen that the workload of anesthesiologists is seriously overloaded.

In the middle of the night, the third watch received a call and rushed to the hospital to anesthetize the emergency surgery patient, which is a common thing.

In addition to the tiring work, it is also very difficult to promote the position of anesthesiologist. The difficulty of grading high is frighteningly high.

In addition, they are basically behind-the-scenes work, and no matter how successful an operation is, their fame will hardly change.

Paying silently behind the scenes, the pressure is even more than that of the chief surgeon, the workload is extremely heavy, and the importance of the work is not lower than that of the chief surgeon. However, the treatment received is very different.

In other words, everyone will feel psychologically unbalanced.

It is precisely because of all kinds of unfair treatment that there is a perennial shortage of anesthesiologists.

Even many medical schools do not offer anesthesiology as a major at all.

This is a question worth pondering in the domestic medical community.

Only by changing the status and treatment of anesthesiologists can it be possible to make more medical students willing to apply for the specialty of anesthesiology.

Otherwise, the problem of shortage of anesthesiologists will only become more serious.

Relying on the leaders to fool the workplace novices into the anesthesiology department is not the solution after all.

Director Hu Kan checked the knife positions drawn on the patient's body, marked the tumor parts, checked them one by one, and started the operation.

An incision is made through the middle of the sternum to complete the thoracotomy.

Compared with the thoracotomy presided over by Xue Yan, Director Hu Kan was as steady as Mount Tai when he did the operation, advancing step by step, giving people a particularly safe feeling.

For so many years, Director Hu Kan has never had a safety accident, which is enough to explain everything.

After thoracotomy, the pleura is folded back and pushed to the sides.

At this point, the thymus tissue located in the anterior mediastinum can finally be seen.

Zhou Can almost just glanced at it, and he had a bad feeling.

The patient's thymoma is ill-bordered, inappropriately colored, and infiltrates with peripheral adhesions.

Adjacent tissues and organs can be seen to be visibly displaced by the tumor.

"This is a malignant tumor, no doubt!"

Zhou Can's heart sank slightly, and the difficulty of today's operation will increase several times.

Malignancy often results in altered anatomical relationships.

There are many uncontrollable risks associated with the excision process.

After Director Hu Kan saw the situation of thymic tumor, Rao had seen countless big scenes and experienced countless difficult surgeries. At this moment, he couldn't help but feel frightened.

The disease is too powerful.

The patient's body has been destroyed to the point of insignificance.

Completely removing the tumor requires a lot of experience and skill from the doctor.

"The fibrous connective tissue sticks together like this, and it's significantly thicker. The risks of surgery are too high. ”

After seeing it, Director Le shook his head.

Ask him to cut it, and he will never dare to cut it.

"No matter how high the risk is, you have to do it! I have done an assessment and discussion before the operation, but I can't see that the situation is not good, so I will sew the patient's chest cavity on, right? ”

Director Hu Kan's tone was full of helplessness.

During his decades-long surgical career, he has encountered countless difficult surgeries.

Which time is not risky?

In the end, he successfully broke through.

This time, he is confident that he will be able to complete the surgery smoothly. This self-confidence comes from his decades of successful experience and decades of hard work.

Every day, he trains his skills, rain or shine, including the stability and coordination of his arms, as well as his concentration.

Long-term meditation has also brought him another unexpected benefit, which is concentration and mental calm.

Many people think that Buddhist zazen and Taoist meditation are superstitious activities, but this is really not. Their reverence for the Buddha or Taoist Ancestor is not a superstition, but a belief.

Superstition and belief are two completely different concepts.

If a person, a nation, or even a country collapses in faith, it is a very terrible thing.

There have been hundreds of schools of thought in Chinese history, but after thousands of years of verification, it has finally been proved that only Taoism can prosper the country. Confucianism and Legalism can only govern the country, and cannot make a country prosperous and strong.

In the course of history, even today, the influence of Taoism on China is still very far-reaching.

Why can't Confucianism and Legalism work? Because Legalism is a harsh law, and it is not close to human feelings. Confucianism can only be reasonable, and in the end, the first emperor was the first to teach Confucianism to be a man.

Just reasoning, if the fist is not hard, can it prosper the country?

There is a classic saying in Taoism that is still regarded as the standard of hospitality by the Chinese people. Friends come with good wine, jackals come with swords.

Huaxia still pursues the Taoist way of treating people first and then soldiers.

Director Hu Kan's insistence on meditation every day can be regarded as both Buddhist meditation and Taoist meditation. As time passed, his heart became more and more peaceful, and his concentration became stronger and stronger.

This is an important support for stabilizing the knife.

can make him as stable as an old dog and not panic in case of trouble.

As long as you stay calm and concentrate at all times, even if you encounter a dangerous situation during surgery, you can calmly resolve it.

"The thymoma has come out, let's just deal with it with all our might. Director Le, it's up to you to lift the lower pole of thymoma. ”

Leaving this work to Ichisuke allows him to concentrate on separating the thymoma from the surrounding tissue.

Zhou Can stood under the operating table and watched Director Hu Kan control the high-frequency electric knife, separating the thymoma from the surrounding adipose tissue one by one. I saw him carefully separated from the bottom up.

"What a powerful separation technique, such a stable knife."

Zhou Can secretly envied himself, if he could practice the separation technique and incision technique to this level at any time, it would be amazing.

In addition to his clever skills and steady knife, Director Hu Kan's concentration is also terrifying.

The number of separations, depth, width, and even speed, as well as the avoidance of peripheral blood vessels and nerves, are breathtaking.

It's a Da Vinci robot, I'm afraid it doesn't have such a high degree of accuracy.

Although many doctors are in awe of robotic surgery, and manufacturers are desperately advocating it, the actual effect of surgery is still up for debate.

Manufacturers tout that robotic surgery is three-dimensional imaging, which can magnify the field of view by 6~10 times, and the degree of freedom of the robotic arm operation is very high, and it can rotate 540, drill into the abdominal cavity and chest cavity like a Monkey King, and cut off everything that should be cut.

But in fact, in addition to its high cost, it also has a lack of haptic feedback and the risk of multiple accidents.

It's actually a very big difference between it and a good surgeon.

Robotic surgery, perhaps, will never be able to replace surgeons.

On the one hand, the development of artificial intelligence is far from perfect, on the other hand, the combination of human thinking and emotion makes the operation full of temperature, and can be quickly and flexibly adjusted to cope with various rapidly changing surgical scenes.

Then there's haptic feedback.

The human skin and nervous system form an extremely complex and sensitive tactile system.

Clever surgeons cut into different tissues and get different feedback on the feel. If you find an anomaly, you can detect it immediately.

The robot is a cold machine and program setting, although there is also manual remote control, but it cuts what should not be cut, and the remote controller has no way to perceive it at the first time.

Robotic surgery, which seems to be extremely accurate, flexible, and relatively few complications, has been unaccepted by patients, and it is not just because of the high cost.

Director Hu Kan's movements were steady and slow, he was very attentive to the operation, and Zhou Can was also very attentive.

Learn from his steady knife style and learn from it.

Then blend into your own quick knife.

Zhou Can likes to think and keep pondering. Some of the advantages will be opposed to his quick knife style, how to integrate, this needs to be thought about hard, and in repeated practice, little by little.

"Whew!"

A very slight abnormal noise emanates from the patient's chest.

This is by no means the sound of a high-frequency electric knife, nor is it the sound that should be felt when cutting body tissue.

Zhou Can's heart tightened, and then he saw blood rushing out.

The closer you are to the heart, the higher the pressure in the blood vessels.

Once an artery or blood vessel ruptures, it is the effect of a water gun.

The others also had solemn faces and stared at the patient's chest.

The god in their minds must have accidentally injured the arteries and blood vessels.

This is not a failed operation, it was just an accident.

"The fibrous connective tissue adhesions thickened, making it extremely difficult to distinguish from the blood vessels, and it was accidentally injured. It's okay, it's okay, stop the bleeding quickly. Director Hu Kan made a statement to stabilize the morale of the army.

His surgical team is also excellent.

Nisuke immediately clamped the broken blood vessel to stop the bleeding.

The blood spray that can have the effect of a water gun is definitely not a small blood vessel. This is already massive hemorrhage.

Don't look at Director Hu Kan is very calm, but if the bleeding cannot be stopped in time, it will pose a serious threat to the patient's life.

"Do you think you should tie this blood vessel first, wait until the separation is complete, and then repair it or how to get it?"

The strength of the second assistant is also not weak.

From the precise clamping and stopping of bleeding just now, his movements were not hurried, fast and accurate, it can be seen that his level of hemostasis is extremely high.

Even if Zhou Can's hemostasis reached the middle level of the main treatment, he was ashamed.

"Let's get ligated first!"

Director Hu Kan hesitated for a moment before replying.

Accidentally cutting such a large artery will definitely cause some psychological interference to Director Hu Kan.

He didn't say it on his lips, he didn't show it on his face, but he had already made waves in his heart.

Strong concentration and deep static force do not mean that you can be as calm as a mirror when you encounter anything.

At most, it's just a matter of staying calm, as he is now.

Zhou Can looked at the artery, his lips moved, and finally he didn't speak.

The second assistant gestured to the third assistant, only to see the third assistant step forward and use skillful techniques to quickly ligate the proximal end of the artery, and the bleeding was temporarily stopped.

As for repairing this artery, you can only wait until the separation is over and cut off the thymoma entirely.

The operation continued.

Less than twenty minutes later, Dr. Yu said in a very confused tone, "The blood oxygen saturation has dropped!" ”

At first glance, it's not!

Normal oxygen saturation is between 95% and 100%.

Usually more than 99%.

At this moment, the patient's oxygen saturation has dropped to 91%, and the warning threshold is approaching.

Zhou Can worked in the intensive care department for three months, dealing with critically ill patients in the intensive care unit every day. So it is very sensitive to oxygen saturation.

In the intensive care unit, if a patient doesn't urinate for two days, there's a good chance that the patient will be gone.

If the patient's blood oxygen saturation is not stable and keeps falling, the patient may go away as long as he is not careful.

So, right now, the patient's oxygen saturation has dropped to 91%, and he knows very well how dangerous it is.

Dr. Yu has extremely rich experience in anesthesia, and he must have sensed the danger, so he reminded Director Hu Kan in such a solemn tone.

"Can oxygen raise oxygen saturation by a liter? The separation operation is less than half underway, and it is estimated that it will take some time. ”

Director Hu Kan's tiger eyebrows have been slightly wrinkled, and his energy is limited.

Now I want to cut out the thymoma as soon as possible, and then I can get that artery and blood vessel thing.

(End of chapter)