Chapter 784： Experience

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The monitor in the operating room screamed monotonously, like a duck with its neck strapped for debt.

Su Jiafu sat smartly on the round stool, looked at the value on the monitor for a while, and looked at the operation of his director, like a duck with a neck around it was hiding debt.

"Combined with propofol and remifentanil, the amount of propofol can be reduced, which can also shorten the recovery time for patients after surgery ..." At the same time, the director of the anesthesia department also gave Su Jiafu a few words.

Ling Ran is accustomed to using Su Jiafu as an anesthesiologist. The two cooperate well, but to improve the prognosis of the operation in all aspects, especially to reduce the recovery time, a good anesthesiologist is very important.

Su Jiafu is a good anesthesia doctor, but his skill tree climbs too low. When he strives for excellence, he can only ask a senior doctor in the anesthesia department.

After the consultation with the anesthesia department, they also came up with the most suitable anesthesia program and adopted total intravenous anesthesia.

Compared to sevoflurane, which is commonly used for full-inhalation anesthesia, remifentanil, which is commonly used for intravenous anesthesia, recovers faster, has a shorter duration of action, and has no savings. Compared with the two, the total probability of postoperative cognitive impairment is lower with total intravenous anesthesia.

Postoperative cognitive impairment is a common complication after general anesthesia. Once it appears, patients may have short-term disturbances in thinking, attention and language skills, and a few may even have long-term disturbances.

Of course, the probability of long-term impairment is very low, and postoperative cognitive impairment mainly occurs in elderly patients. In addition, the higher the education level, the lower the probability of postoperative cognitive impairment.

As far as the working status of the patient Chen Xiaowang, even the cognitive impairment in a short period of time is probably unbearable. The Department of Anesthesia was named by Huo Congjun. Although the director of the department was not a bad Huo Cong, he could not let him be seen. The options chosen are considered in many ways.

People who have been flattened by Huo Congjun will be sprayed by others if they are not good, and they will be sprayed with indifference. As the director of the anesthesiology department, naturally they cannot accept this crime.

The director kept watching the data on the monitor stable, and then watched Su Jiafu filling out a list on the computer, and then pointed at the dosage of various medicaments, saying: "The next time you do it, you must have a number in your heart. Don't be foolish. Like cistracurium, if it is used during induction, the amount must be controlled. For dexmedetomidine, more attention should be paid to the fact that hypotension is used and bradycardia ... "

Su Jiafu listened obediently, like a trained puppy.

For Su Jiafu, who is still a resident, getting director training is also a rare opportunity.

The anesthesiology department is more busy than ordinary professional departments. If the doctors in other departments reach the level of director and there is a little easier space, the director of anesthesiology department often has to work on the front line.

The so-called only minor surgery, no small anesthesia, once the department director of the anesthesiology department enters the battlefield, he must be serious and really do things, not easy, and the net newcomers every year, unless someone asks, the director is idle.

It can be said that the growth of a doctor is inevitable. It is also very metaphysical about the level of doctors who two newcomers are hospitalized. In many cases, it is not the quality of the newcomers' performance, but the attitude of the superior doctor and the level of busyness.

Su Jiafu had not had the opportunity to listen to the director's lecture before, but now that she has the opportunity, she cherishes it.

Similarly, Lu Wenbin and Ma Yilin in front of the operating table also performed the operation with serious faces.

They can all see that Ling Ran's approach today is very different.

Surgeons do operations that are often rough, and the more professional they are, the worse they are sometimes. This is like bringing a child. The parents who took the first child are really patient and worried about the child. Will they be nervous when they see that they are turning over? However, the attitudes of the parents of the second child and the parents of the third child are definitely different.

Ordinary surgeons, when performing the first appendix surgery or the first cholecystectomy, are absolutely trembling, for fear of making mistakes-of course, they are bound to make mistakes.

However, when the 10th and 20th operations are performed, some habitual rough operations and illegal operations will begin to appear. By the 100th operation, the surgeon will not only form his own routine, but also form Your own rough method. It's like a used driver who has been driving for two years. The operation is as fierce as a tiger.

In contrast, Ling Ran has always been strictly required, but not to the point of being critical.

After all, the human body is different, and it doesn't make sense to emphasize a uniform value or to stick to a particular red line.

It seems that Ling Ran's requirements today are unusually high.

Even the output frequency of the ultrasonic knife and so on are adjusted to keep changing, making Lu Wenbin and Ma Yilin unconscious.

Ling Ran is still in a silent state. To be honest, I can say that he had said it during the pre-operative consultation. His current operation was completely tried out.

Ultrasonic blades are medical instruments that rely on high-frequency vibration to complete cutting and coagulation. To a certain extent, this kind of blades with the highest frequency that can reach more than 50,000 HZ is already quite a black technology.

The greater the energy output, the stronger the cutting ability, and the lower the energy output, the weaker the cutting ability, but the stronger the ability to coagulate and stop bleeding.

The same doctor, using an ultrasonic knife to perform surgery is faster than using an electric knife ~ www.novelhall.com ~ more than a third, the effect will be better.

Not to mention, it is also hemostatic. It can be done with an ultrasonic knife for 1 second, and an electric knife takes 5 seconds.

The extra 4 seconds, the electric knife has been leaning on the organization, and the damage will definitely be more.

The ultrasonic knife will also be damaged, so Ling Ran must choose the appropriate frequency and time, which can complete the cutting and coagulation without damaging the tissue.

Even the angle of the titanium clip is specially adjusted and tested.

At that time, when the abdomen is closed, the bile duct and other tissues are squeezed together. In addition to the natural peristalsis of the body, the titanium clamp is not placed well, and it is easy to have complications.

However, these are all small-probability events. If it was not the request of the patient Chen Xiaowang, it would not have been so detailed.

But from another perspective, it was exactly his requirements that gave Ling Ran a template and a goal.

Clinical medicine, in many respects, has no specific data. Lower the energy of the ultrasonic knife. How low? Pay attention to the titanium clip. What is the specific angle? There are no formulas.

The value of surgeons is often reflected in this.

The experience of a surgeon is accumulated through countless operations and countless thoughts. Follow the right steps and do the right things. Over time, the success rate has increased.

In contrast, the development of evidence-based medicine is still a baby, and every step is evidence-based and cannot be done.

But to do a patient well, follow the model of a patient, do more and better, for a surgeon, it can be done.

Perhaps the world will not change dramatically.

But it will make the world more hopeful and better.

...

Flying to Beijing again, the party of "Internet Literature +" asked me to sing a song ...