Beep — Beep —
The monitor in the operating theater beeped in a monotonous tone, like a duck that was being strangled by the neck asking for a debt.
Su Jiafu sat obediently on the round stool. He looked at the numbers on the monitor for a while, and then looked at his department director's operation. He was like a duck that was being strangled and trying to avoid paying a debt.
"Use propofol and remifentanil together. The amount of propofol can be reduced, which can also shorten the patient's postoperative recovery time …" The department director of the Department of Anesthesiology also gave Su Jiafu a few words as he operated.
Ling Ran was used to using Su Jiafu as the anesthesiologist, and the two of them worked well together. But to improve the prognosis of the surgery in all aspects, especially reducing the recovery time, a good anesthesiologist was very important.
Su Jiafu was considered a good anesthesiologist, but his skill tree was too low. When it came to improving, he could only ask the senior doctors in the Department of Anesthesiology to come forward.
After the consultation of the Department of Anesthesiology, they also came up with the most suitable anesthesia plan, which was to use total intravenous anesthesia.
Compared with sevoflurane, which was commonly used for inhalation anesthesia, remifentanil, which was commonly used for total intravenous anesthesia, had faster recovery time, shorter effect time, and less accumulation. Compared with the two, the probability of postoperative cognitive impairment was also lower with total intravenous anesthesia.
Postoperative cognitive impairment was a common complication after general anesthesia. Once it appeared, the patient's thinking ability, attention, and language ability may be impaired for a short period of time. A few people may even have long-term impairment.
Of course, the probability of long-term impairment was very low, and postoperative cognitive impairment mainly occurred among elderly patients. In addition, the higher the patient's education level, the lower the probability of postoperative cognitive impairment.
With Chen Xiaowang's working condition, even short-term cognitive impairment might be unbearable. The department director of the Department of Anesthesiology was appointed by Huo Congjun. Although the department director was not afraid of Huo Congjun, he could not let Huo Congjun look down on him. He chose the plan after considering many aspects.
Those who were looked down on by Huo Congjun would be scolded by him if they were not careful. As the department director of the Department of Anesthesiology, he naturally could not bear this kind of humiliation.
The department director kept looking at the stable data on the monitor and watched Su Jiafu fill in the form on the computer. He then pointed at the dosage of various drugs and said, "Next time you do it, you have to have an idea in mind. Don't just foolishly calculate. For example, if you use cisatracurium during induction, you have to control the dosage well. You have to pay more attention to dexmedetomidine. If you use it too much, you will have low blood pressure and bradycardia …"
Su Jiafu listened obediently, like a trained puppy.
For Su Jiafu, who was still a resident doctor, it was a rare opportunity for him to receive training from a department director.
The Department of Anesthesiology was a busier place than ordinary specialized departments. Doctors from other departments who had reached the rank of department director would have a slightly easier time, but the department director of the Department of Anesthesiology often had to work on the frontline.
As the saying went, there were only minor surgeries, but no minor anesthesia. Once the department director of the Department of Anesthesiology went to work, he also had to work seriously, and he could not relax. Every year, there would be a large number of new people in the department, and unless they were asked by someone else, the department director would ignore them.
It could be said that a doctor's growth was also inevitably due to coincidences. It was also very metaphysical to see what level of teaching two new resident doctors could receive. Most of the time, it was not the performance of the new resident doctors, but the attitude of the senior doctors and how busy they were.
Su Jiafu did not have the chance to listen to the department director's lectures in the past. Now that he had the chance, he naturally cherished it.
Similarly, Lu Wenbin and Ma Yanlin, who were in front of the operating table, also performed the surgery with serious expressions.
They could all see that Ling Ran's technique today was very different.
Most of the time, surgeons were actually very crude when they performed surgeries. The more professional a doctor was, the cruder they were sometimes. This was just like taking care of a child. Parents who took care of their first child were really patient and worried about their child. When they saw their child turn over, they would be nervous and worried that they would squash their arms. However, the attitude of parents who took care of their second child and third child was definitely different.
When general surgeons performed their first appendectomy or their first cholecystectomy, they would definitely tremble with fear, and they would be afraid of making mistakes. Of course, they would definitely make mistakes.
However, when it came to the tenth or twentieth surgery, some habitual rough maneuvers and illegal operations would start to appear. When it came to the hundredth surgery, surgeons would form their own routines, and they would also form their own unique rough maneuvers. It was just like a semi-new driver who had been driving for two years. His operation was as fierce as a tiger, but when you looked at it again, it was all a blind operation.
In comparison, Ling Ran had always been strict in his work, but he was not to the extent where he was nitpicking.
After all, the human body was different. It was meaningless to emphasize on a uniform value or to stick to a specific red line.
However, Ling Ran's requirements today were unusually high.
Even the output frequency of the ultrasonic knife was adjusted here and there. It kept changing, causing Lu Wenbin and Ma Yanlin to feel that it was amazing even though they did not understand it.
Ling Ran was still silent. Honestly speaking, he had already said everything he could during the preoperative consultation. His current maneuvers were all based on trial and error.
The ultrasonic knife was a medical device that relied on high-frequency vibration to complete cutting and coagulation. To a certain extent, this kind of knife head, which could reach a maximum frequency of more than 50,000 Hz, was already quite advanced.
The higher its energy output, the stronger its cutting ability. If the energy output was low, the cutting ability would be weak, but its ability to coagulate and stop bleeding would be strong.
If the same doctor used an ultrasonic knife to perform a surgery, it would be more than one-third faster than using an endotherm knife, and the effect would be better.
Forget about other things, just the same bleeding control could be done in one second with an ultrasonic knife, but it would take five seconds with an endotherm knife.
During the extra four seconds, the endotherm knife would continue to rely on the tissue, and it would definitely cause more damage.
The ultrasonic knife would also cause damage. Therefore, Ling Ran had to choose the appropriate frequency and time to complete the cutting and coagulation process without damaging the tissue.
Even the angle of the titanium clip was specially adjusted and tested.
When the abdomen was closed, the bile duct and other tissues would be squeezed together. Coupled with the natural peristalsis of the body, if the titanium clip was not placed properly, it would be very easy for complications to occur.
However, these were all low-probability events. If it were not for the patient Chen Xiaowang's request, there was no need to be so detailed.
But from another perspective, it was also because of his request that Ling Ran had a template and a goal.
In many aspects of clinical medicine, there was no specific data. Lower the energy output of the ultrasonic knife. How low? Pay attention to the titanium clip. What was the specific angle? There was no formula.
The value of a surgeon was often reflected in this.
A surgeon's experience was accumulated through countless operations and countless times of thinking. Following the correct steps and performing the correct operations, the success rate would increase over time.
In comparison, the development of evidence-based medicine was still a baby. Every step was based on evidence, and it was impossible to do it.
However, it was possible for a surgeon to perform well on a patient, follow the patient's pattern, and perform more and better on the patient.
Perhaps the world wouldn't be turned upside down because of this.
But it would make the world more hopeful and better.
…..
I flew to Beijing again. The organizers of the "Online Literature +" conference asked me to come over and sing a song …
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