Start From Emergency Doctor

Chapter 436

This part-time electron microscope monitoring anesthetist was specifically asked by Zhou Yuan before the operation.

The anesthesia method for intraoperative wake-up is a compound anesthesia, and it is necessary to select the type of anesthetic agent, the amount of anesthesia, etc. according to the operation time, surgical technique, and patient’s condition, which is much more complicated than ordinary surgical anesthesia.

In addition to basic anesthesia, adequate cranial nerve block, refined TCI and BIS intraoperative anesthesia depth management are also needed to control the patient’s wakefulness during anesthesia.

One more thing to note is that craniotomy is likely to induce epilepsy, nausea and vomiting, as well as irritability and violent arousal after awakening, all of which need to be controlled by an anesthesiologist.

Only by perfecting all the details can it be possible to complete the intraoperative wake-up and to perfectly remove the tumor with the electron microscope signal.

“Add ropivacaine to perform nerve block and incision infiltration for the patient.” Zhou Yuan said.

The main source of pain during intraoperative arousal is the surgical incision.

Although there are no painful nerves in the brain, there are on the scalp. Under the stimulation of pain, patients who are awakened during the operation are more likely to have bad emotions.

The anesthesiologist was already prepared, and stepped forward to give the anesthetic again.

At the same time, all the related anesthetics had been stopped. After waiting for almost 30 seconds, Yang Lin finally woke up.

“How much is five plus three?” Zhou Yuan asked quickly.

“?” Yang Lin was stunned.

What happened so terribly?

“Where am I?” Yang Lin asked subconsciously.

He also wears an oxygen mask on his mouth, so he speaks very vaguely.

Zhou Yuan glanced at it and said, “Tear off the oxygen mask.”

Yang Lin panicked all of a sudden, his eyes widened: “You can’t pull it! I can save it! You can’t pull it!”

Jiang Xiaoqi pulled off the oxygen mask: “It’s just for decoration, but there is no oxygen.”

Yang Lin:…

Zhou Yuan briefly explained the situation, and Yang Lin quickly understood what was going on now.

In fact, intraoperative awakening should be communicated with the patient before the operation to avoid accidents, such as frightening the patient. ’

However, Yang Lin’s operation cannot be delayed. Zhou Yuan also decided to wake up during the operation shortly before the operation.

“Cooperate well, your wife and they are still waiting for you to go back to celebrate the New Year.” Zhou Yuan said lightly.

Yang Lin, who was still a little scared, didn’t know why he suddenly fell silent, and for a moment he felt very relieved.

This is also the reason why Zhou Yuan dared to directly initiate intraoperative wake-ups-his 10% language affinity allows him to calm down the patient immediately.

“Dad.” Yang Lin said.(Read more @ wuxiax.com)

Zhou Yuan’s expression freezes.

Someone is undergoing surgery, who is your dad? !

Yang Lin: “Oh, I mean five plus three equals eight. Didn’t you ask me before?”

Zhou Yuan:…

“Hehe, your reflex arc is quite long.”

Yang Lin: “I have a good memory.”

Zhou Yuan suddenly regretted waking up Yang Lin. Why did this guy talk so much after his head no longer hurts?

“Let’s start the operation.”

Zhou Yuan sighed and stopped talking nonsense.

Xiao Xuemo and others did not have much experience, so the anesthesiologist stepped forward to assist Zhou Yuan to help Yang Lin stay awake.

Holding a few prepared picture cards in his hand, he asked Yang Lin “apple” and “pear” and some simple addition and subtraction.

“How do you feel now? You look at the picture in my hand and tell me what is on the picture.” the anesthesiologist asked.

“This picture is a banana.” Yang Lin’s voice was very determined.

“Move your toes.”

Zhou Yuan stared at the electron microscope monitoring.

After Yang Lin received instructions to move his toes, there was an immediate reaction on the electron microscope monitor.

Zhou Yuan took advantage of Yang Lin’s chat with the anesthesiologist and raced against the clock to start removing the tumor.

The anesthesiologist stimulated the functional area near Yang Lin’s tumor. If the electron microscope monitor responds, it means that this brain area is useful and needs to be preserved. Otherwise, if there is no response, it can be removed.

In this case, the tumor can be as completely clear as possible, and the patient’s functional area can be preserved to the greatest extent.

After some parts are stimulated, Yang Lin suddenly loses his language ability. Some parts can speak after being stimulated, but they cannot be expressed in words. These are Yang Lin’s control areas such as language and actions, and must be avoided during excision. open.

Xiao Xuemo and the others were stunned.

This scene is really shocking…

Xiao Xuemo, He Jianyi, Jiang Xiaoqi and others have undergone operations for so many years, except for some that do not require general anesthesia, they have never performed surgery when the patient is still awake.

What’s more, Yang Lin’s head is still open now!

Just talk to a person whose brain is exposed to the air, and the other person will be stimulated to the function area and behave abnormally, very weird…

Fortunately, Zhou Yuan’s speed was very fast. After about eight minutes, Zhou Yuan finally worked out a surgical route based on the results of the electron microscope inspection.

After the route was determined, the anesthesiologist restarted injecting the anesthetic, increasing the dose, and Yang Lin entered the state of general anesthesia again.

“Next to you.” The anesthesiologist said respectfully, and stepped aside.

Zhou Yuan smiled, picked up the scalpel, and started to formally remove the brainstem tumor.

“Your anesthesia skills are very good.” Zhou Yuan said lightly.

He rarely praises people. On the one hand, Zhou Yuan is too young. Most of the people present are Zhou Yuan’s elders, and even his peers are rarely younger than Zhou Yuan.

And Zhou Yuan’s current identity is destined to be that no matter how he praises others, others will treat them as the tone of superiors to subordinates…

Imagine a kid patted his shoulder and said that you are fine. This scene is too spicy. ‘

But out of Zhou Yuan’s expectation, the anesthesiologist actually laughed happily, “Thank you!”

Zhou Yuan smiled.

He was telling the truth.

Intraoperative awakening requires the anesthetist to be particularly high, allowing the patient to switch back and forth between sleep and awake, and occasionally feel no pain when waking up. The anaesthetist needs to accurately control the sedation and tranquilizing drugs, plus the anesthesiologist He also serves as an electron microscope monitor, even if he is the director of the anesthesiology department, it is more than enough.

The next operation will be much easier.

After determining the scope of tumor resection, the biggest problem of brainstem tumor resection is basically solved, and then only need to follow the route marked during Zhou Yuan’s wake-up phase to perform the cut.

Under the microscope, Zhou Yuan’s knife was floating on the surface of the brainstem, dropping from time to time, making a light cut, and then cutting diagonally across the scalpel.

Zhou Yuan’s movements are very gentle. Although there is no abundant blood supply system in the tumor, blood vessels still exist after all. If the blood vessels in the tumor are accidentally punctured, it may cause the spread of tumor cells.

Even if there is no spread, intraoperative bleeding is not a good thing. .