Friday afternoon, the operation of a huge malignant fibrous tissue sarcoma is preparing to start…
Because the tumor grows deep in the trapezius muscle of the neck, intubation is undoubtedly difficult. In addition, lateral recumbency, and possibly even changing positions, may affect airway safety. Therefore, the Department of Anesthesiology formulated a detailed intubation plan and intraoperative airway protection measures.
Because of good preparation, the anesthesia process was smooth. But because the tumor is too big and too deep, it still creates a lot of trouble for the surgery.
The trouble of surgery is the trouble of anesthesiology. In the smallest case, the operation time is significantly prolonged; in the largest case, it may be a “roller coaster” rescue.
What to say: During the operation, despite the use of electrocautery, there was no way to control the bleeding to a level that would not require blood transfusion.
Through an urgent blood gas analysis, the anesthesiologist believes that the patient’s blood routine has reached its limit. Therefore, the component blood is urgently called for blood transfusion therapy.
After the intervention of vasoactive drugs, the patient’s circulation indicators made everyone feel relieved.
Wipe off the sweat and look on the operating table, the tumor has been completely removed.
Due to the skin violation, the surgeon had to remove all the dangerous skin.
But in this way, there is a large piece of skin on the neck less. Therefore, a temporary step was added to the operation – skin grafting.
However, since the skin required is very large, the amount of skin removed from the patient’s torso at one time is not sufficient. So, the surgeon decided to take the approach of perforating the skin. By making a small incision in the skin with a razor blade, the skin can be doubled.
Thinking of this method, the surgeon showed a happy expression.
However, such an operation requires covering with an extremely soft dressing. Not only soft, but also consistent strength everywhere. Otherwise, there may be local skin necrosis and skin grafting failure.
At this moment, the surgeon turned to look at the instrument nurse on the stage.
This nurse has been working for a few years, and she doesn’t know what a surgeon means.
When “the second monk was confused”, the surgeon said with a smile: Sister Nurse, can you cut some gauze pieces?
Young nurses can’t stand this, and immediately say yes, yes, yes.
However, this was destined to be a decision she regretted.
Because everyone on and off the stage was waiting for her gauze piece, the young nurse stepped up the speed of her scissors.
Ten minutes later, a hill of gauze pieces was piled up in front of the surgeon.
Don’t look at it for only ten minutes, the anesthesiologist’s heart has become more and more anxious, and the blood pressure also goes up. Fortunately, the gauze has been cut, and the blood pressure gradually recovered.
Someone said, what are you anxious about as an anesthesiologist?
Be aware that over time, more anesthetics enter the patient’s body. The effect of anesthesia recovery is different for different surgeries. For example, most surgeries for appendicitis are better than longer surgeries such as gastrectomy.
After the surgeon finished the last stitch, the patient’s eyelids moved slightly.
This move made the anesthesiologist breathe a sigh of relief. This means that patients can basically wake up on time.
Ten minutes later, the anesthesiologist successfully extubated the patient.
I was about to call the roving nurse to push the patient to send the patient. The anesthesiologist saw that the roving nurse was busy flushing the hands of the instrument nurse with disinfectant.
Let’s take a look, good guy: two big blisters on two fingers! Also, the skin of the blister is already incomplete. The pink exudate and disinfectant are mixed together, which makes people feel distressed.
The anesthesiologist, who couldn’t bear to see him again, returned to the patient and continued to inhale oxygen for the patient.
Seeing that the nurse’s hand was injured, the surgeon was not in a hurry.
After another half day, the head nurse came. Seeing the nurse’s hands like that, he blamed and said helplessly: “What’s the hurry, I can’t cut it slower!”
The second operation has been replaced by another nurse. Obviously, the young nurse was useless. Still too young!
[Warm reminder] Please pay attention, here are a lot of professional medical science, to reveal the secrets of surgical anesthesia for you~