"Do you know anything about the latest techniques of stellate ganglion block anesthesia?" asked Wu Mianwen.

"......" Peng Peng was stunned.

The latest technology? What is that? Peng Peng subconsciously shook his head.

"It's not the latest, it's just a little trick, and I think it's quite useful. Wu Mian said.

"Mr. Wu, please speak. Peng Peng suppressed his curiosity and said.

"Let's talk about the problem first, technology is not something that can be learned in a day. Wu Mian continued, "Just looking at your expression, I feel that the process of this block anesthesia ...... It didn't go well at first, did it?"

"Hmm. Peng Peng didn't squirm like a shy man, and nodded directly to admit, "There is no problem with this patient's preoperative physical examination, and I thought that the block anesthesia would be completed soon." However, when I was doing the stellate ganglion anesthesia, I tried it 3 times, and I had bleeding in the first two times, and there was no blood until the third time. ”

"There was a small amount of blood withdrawn during the first two injections, and after giving up the injection, the needle was inserted deeper in the third injection than in the first two injections.

When the tip of the needle touched the bone, I heard you say that the needle was not withdrawn, it is estimated that the left hand is not stable, and the tip of the needle continues to slide into a little, resulting in too deep needle insertion, although there is no blood and cerebrospinal fluid in the retraction, but the needle tip is too tight, and there may be no blood in the retraction, and the possibility of mistaking into the blood vessel cannot be ruled out."

Wu Mian looked back at Director Peng's previous operation, and the more Director Peng listened, the more surprised he became, how could he see it with his own eyes...... No, you won't see the tip of the needle touching the bone when you operate with your own eyes, and there is no needle withdrawal.

It's like traveling to Mr. Wu's body and telling himself about the previous wrong process. And it is also in their own hazy realization that the process of operation is not determined.

In an instant, Peng Peng felt that he was split and exploded directly.

He looked at Wu Mian in a daze, how did Mr. Wu know about the most private thing in the operation?

"Hehe, don't be weird. Wu Mian smiled, "I'm just making inferences based on normal guesses, generally speaking, the situation will only occur when the anesthetic is injected into the vertebral artery, which is a high probability." ”

"There is a saying that a happy life is the same, but an unhappy life has its own misfortunes. It's a similar situation with our operation.

It's just that because of the different anatomical structure of each person's body, each success may be a little different, but most of the failure cases are the same. ”

Wu Mian looked at Peng Peng with a smile on his face, as if he was lecturing to students, but he was not too harsh.

"Teacher Wu, you are amazing. Peng Peng praised dryly, he wasn't sure what Wu Mian was talking about, but it was always right to say two good words.

"In the horizontal section of the 7th cervical vertebra, the vertebral artery has not yet entered the transverse foramen and its proximity to the stellate ganglion may be an anatomical factor in the occurrence of puncture into the vertebral artery. I'm sure you've noticed, but the problem still happens. ”

"To avoid...... It is not possible to avoid it completely, and at least one set of endotracheal tubes should be available after intubation. Wu Mian said, "Then there is the stellate ganglion anesthesia under ultrasound guidance." ”

"Ultrasound? ”

"That was in the past, and neither the technology nor the machines were up to par. Wu Mian said with a smile, "The first two generations of B-ultrasound machines have been able to see the diffusion of local anesthetic drugs during injection. ”

“......”

Peng Peng, Zhang Zimo and the other three were stunned.

The carotid artery and vertebral artery blood vessels are relatively thick, and it would be better to say a little if the blood flow could be seen on the bedside B ultrasound. Can B-ultrasound see the penetration of local anesthetic drugs?

Are you sure you're not kidding?

"Ultrasound-guided direct vision block is safer and more reliable than traditional block methods by palpation of the transverse process, which not only avoids vascular injury and accidental entry into the vessel, but also reduces the amount of local anesthetic. ”

"The traditional method requires 8~10mL of 1% lidocaine, and 2~3mL under ultrasound guidance. It also has a faster onset of action than traditional blocking methods. Smaller dosage and safer. ”

After Wu Mian finished speaking, he looked at Director Peng with a smile.

Wu ...... Teacher, are you talking about difficult technology?" asked Director Peng with a slight stammer.

The moment he heard Wu Mian finish speaking, Peng Peng felt that his throat was a little dry, and he began to speak uncomfortably.

"You want to learn, I'll teach you. Wu Mian said with a smile.

"Really?!"

Peng Peng realized the benefits of this matter, even earlier than Zhang Zimo and Director Qian. After all, he is a veteran driver.

Teacher Wu Mian Wu said that this technology is not only safer and more reliable, if you can use B-ultrasound positioning and supervision, you can withdraw from it and take a few apprentices.

Someone can handle various operations before and during the operation, and you only need to hold the B-ultrasound probe for guidance. Now I am busy until seven or eight o'clock in the evening every day, and the amount of one person who can do it is still limited.

And the most critical point is that Peng Peng doesn't want to let go.

The old director was eviscerated from time to time, so Peng Peng would rather work later every day than do the things of church apprentices and starve the master to death.

But with the new technology, things are completely different! In Peng Peng's mind, a new map for the future has been outlined.

If there is B-ultrasound positioning all the time during the operation, it is equivalent to the most difficult blind puncture step is omitted, and he is responsible for guiding the puncture, and the young doctor is responsible for manual puncture.

It can also efficiently and safely increase the number of patients treated, and master the upstream core technology!

As he gets older and has more and more patients, Peng Peng has been feeling a little powerless recently.

People have to obey the old, and this kind of inability is scattered around life from home to work.

But once the roles are reversed...... Peng Peng suddenly felt that his eyes suddenly opened up, and a blue ocean was waiting for him!

Wu Mian was just smiling, looking at Director Peng's unpredictable expression, smiling and not saying a word.

Thinking of these, Peng Peng's heart was hot.

"Mr. Wu, what are the techniques you are talking about......"

"The technique is very simple, the main thing is to distinguish the vascular nerves. As for the infiltration of anesthetic drugs, let me be honest, it takes at least 10,000 clinical operations to accumulate before you can initially master it. Wu Mian said.

"That's okay!" Peng Peng said, "Teacher Wu, when do you have time?"

Zhang Zimo glared at Peng Peng, what he said was too rude.

Peng Peng didn't realize his rudeness at all, and looked at Wu Mian excitedly.

"Don't worry, you can familiarize yourself with B-ultrasound first. Wu Mian said with a smile, "First of all, you need to understand how to define the linear array probe, the frequency of 9~13 MHz, and then how to swing the direction of the probe with the sagittal plane of the neck at 30°~45°." If these basic skills are done, we will contact you at any time. ”

Hearing Wu Mian say this, Peng Peng's head was big.

He knew that the ultrasound probe seemed to be a high-frequency linear array probe, but although Mr. Wu said it simply, would it have a deeper meaning?

Is it possible to dismantle the B-ultrasound machine and start from the most basic?