He placed the pregnant woman on the operating table and adjusted the angle of the bed to 15 degrees to the left.
This was to allow the pregnant uterus to move to the left, making it easier to locate the appendix. At the same time, it could reduce the stimulation of the uterus during the surgery to prevent complications such as threatened abortion.
The preoperative preparations were quick and Xie Yiren was already in position.
Zheng Ren scrubbed his hands, put on his clothes, spread the sterile drapes and stood in the surgeon's position.
"0.5% lidocaine and half a bottle of milk," Zheng Ren said.
Milk was another name for propofol, an anesthetic inducer usually used during general or continuous epidural anesthesia. Local anesthesia was not very effective.
The anesthesiologist was startled. He wanted to argue but held back when he saw Zheng Ren's focused expression.
If he dared not use anesthesia for a pregnant appendicitis, what else would he not do?
"Replace the 5ml syringe with a 1ml syringe needle." Zheng Ren stood under the shadowless lamp, his silhouette slightly imposing. Every word was extremely firm and could not be questioned.
The thinner the syringe needle, the less pain it would cause to the patient, but the more difficult it would be to deliver the anesthetic.
The anesthesia began. The skillful and rhythmic movements made the anesthesiologist feel refreshed.
After each injection, he would pause for a few seconds to wait for the propofol mixed with lidocaine to take effect before proceeding with the next step. His technique was gentle but accurate. From the patient's vital signs, there was no needle-like pain caused by the syringe.
No wonder he dared to perform an appendectomy under local anesthesia.
The anesthesiologist was a knowledgeable person and the more he watched, the more fascinated he became.
In the surgical demonstration room, Old Chief Physician Pan and Chief Surgeon Liu exchanged expressions.
When he saw that the patient had appendicitis in pregnancy, Old Chief Physician Pan put down the old Tracheostomy Chapter.
When he saw that Zheng Ren was preparing for local anesthesia, Old Chief Physician Pan became anxious.
"Old Chief Physician Pan, you have a good eye." Chief Surgeon Liu was confident that victory was within his grasp. Zheng Ren had no one to blame but himself for courting death. He was now in a relaxed mood and began to trash talk his overconfident opponent. "I haven't performed an appendectomy under local anesthesia for many years. Old Chief Physician Pan, you must have done it often when you were in county and township hospitals or in the army. Zheng Ren probably learned it from you. Today, I'll learn from you and improve my skills. "
After saying that, Chief Surgeon Liu changed to a more comfortable position and smiled as he watched Zheng Ren begin local anesthesia on the projection.
Old Chief Physician Pan wanted to retort, but he was not in the mood to do so.
It was already midnight when hundreds of accounts logged into Xinglin Garden's website at the same time. They whizzed over and squeezed into a live video stream.
[Oh my god, what am I seeing? Appendicitis in pregnancy! He even needed local anesthesia! Is the Almighty trying to court his own death?]
[What do you know? Sit down properly, you're blocking my view.]
[I've never done appendicitis under local anesthesia before. I'll have to learn it well this time. I hope the Almighty can do it slowly. I'll inform the others to come and take a look.]
[Have you ever performed an appendectomy under local anesthesia? I've never done it before. I'm just going to sit on a stool and learn from the Great God.]
[Never done it + 1]
[Never done it before + 2]
[…]
[Never done it + 10086.]
There was a doctor behind every account in Xinglin Garden. This was a professional website that required real name authentication and a medical practitioner's certificate as the review standard.
The basic anesthetic method for appendectomy was continuous epidural anesthesia, which was very common. Those who stayed up late were all young doctors in their thirties. None of them had ever performed an appendectomy under local anesthesia, even if they were professional doctors.
[Why is the anesthetic in his syringe cloudy?]
[I think I heard propofol being added. Is there anyone from the anesthesiology department? What's the theory behind this obnoxious operation?]
[I'm the deputy chief physician of the anesthesiology department of a Class Three Grade A hospital. I don't understand at all.]
The group of professional doctors entered a state of confusion as soon as the surgery began.
There was no doubt that appendectomy under local anesthesia was an unfamiliar surgical method. They could not even understand the anesthetic being injected by the surgeon? That was a little too much.
Comments flooded the screen.
[Why does he have to stop for a few seconds after each injection? What's the theory behind this?]
[It's probably to prevent the local anesthesia from taking effect and to avoid agitating the patient. 0.5% lidocaine infiltration anesthesia usually takes about 12 seconds to take effect. Why is the interval between injections around three seconds?]
[Is this the effect of propofol?]
[I've already knelt down. Please accept my knees, god.]
[Stop spamming the screen. Watch the surgery! Watch the surgery!]
In the end, the bullet comments from the people who called for quiet surgery were drowned out by a dense wave of bullet comments and disappeared in the sea of people.
[I remember an appendectomy during pregnancy. The textbook states that the McBurney's point is the right rectus abdominis muscle. Why does the god's incision seem a little higher? Did I remember wrongly?]
[Maybe he did a physical examination to determine the position of the appendix.]
[How confident must he be to perform a mid-pregnancy appendectomy with a small incision of five centimeters?]
Although it was only an appendectomy, everyone was watching with great interest. As the surgery began, the comments gradually dwindled.
…
…
Zheng Ren used a scalpel to cut open the skin, blunt dissection of the subcutaneous tissue and muscle, and opened up the peritoneum.
Every step of the operation had to be anesthetized with local anesthetics. The surgery was not fast, but it was very stable.
The anesthesiologist looked at the surgery, the ECG monitor, and then the surgery. The peritoneum had been reached, and the patient's blood pressure, heart rate, and breathing were stable.
This meant that the effect of local anesthesia was very good. The patient did not feel any pain.
'What a monster,' the anesthesiologist thought.
Zheng Ren had done his best. Even an anesthesiologist would not have performed so perfectly. Could it be the effect of propofol? Should he test it during the next surgery?
The anesthesiologist quickly shook his head and chased the unrealistic thought out of his mind. It was better for him to perform the anesthesia. If there was an accident, he would not be able to bear the responsibility.
After cutting open the peritoneum, Zheng Ren used the curved forceps to clamp the appendix out.
The curved forceps were held in place, not giving any extra strength to the swollen and fragile appendix.
He held the curved forceps in one hand and extended the other in front of Xie Yiren.
The small curved forceps was placed in Zheng Ren's hand.
"No small curved forceps." Zheng Ren slapped the small curved forceps back and said, "Syringe."
Xie Yiren realized that this was not the appendectomy she was used to. It was an appendectomy under local anesthesia. The ligaments and arteries around the appendix could not be clamped directly, so local anesthesia was needed.
Xie Yiren, who was tired of the appendectomy, had her eyes twinkling as if she had found a new toy. She stared intently at Zheng Ren's movements.
After injecting the anesthetic, Zheng Ren picked up the small curved forceps and started dissecting the ligaments.
Zheng Ren felt unlucky to encounter a pregnant appendicitis patient at a time of life and death, and to perform local anesthesia on top of that.
Although he had practiced local anesthesia in the System, he would try his best not to perform such an extravagant procedure. There were too many accidents.
Fortunately, this case of appendicitis in pregnancy was a relatively simple case of appendicitis.
Due to pregnancy, the uterus was swollen and the greater omentum, which was supposed to cover the appendix, was pushed away. If the appendix was perforated, the patient would have serious complications without the protection of the greater omentum, and intraoperative management would be very troublesome.
The patient in front of him was not sure if the diagnosis was accurate and timely, or because she was too young, healthy, and had high immunity, but the appendix was swollen to its limit without perforation.
The inflammatory exudation around the appendix was not severe either.
How fortunate.
Zheng Ren removed the appendix and sutured the appendicular artery. After suturing the stump of the appendix with a purse-string needle, he added another suture.
The surgery was done cleanly and beautifully.
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