On an early summer afternoon, the largest operation since the establishment of the hospital was being performed in the operating room: the patient had a huge tumor in the abdominal cavity. Huge tumor, causing patients to breathe has become a problem.
Before the surgery, all eyes were on the anesthesiologist. What everyone means is that as long as the anesthesiology department dares to anesthetize, there is hope for this operation to be put on the agenda.
Emotionally, the anesthesiology department is holding back: if the anesthesiology department dares to be anesthetized, will you dare to operate? What do we dare not anesthetize? However, different patients have different risks. Just from the point of view of anesthesia technology, how can there be so many anesthesiologists can not solve?
In this operation, the difficulty of anesthesia lies in the establishment of a safe artificial airway, the hypotension syndrome in the supine position that may be experienced during the operation, and the problem of massive blood loss when dealing with tumors.
With the development of a detailed preoperative anesthesia plan, the operation went smoothly.
During the operation, it was thrilling: the tumor seemed to have countless nourishing blood vessels. After all the blood vessels have been processed, the blood loss has already exceeded 3,000 milliliters.
If the anesthesiology department hadn’t carried out blood dilution in advance, and had prepared a large amount of fluid and blood components in advance, problems were very likely to occur.
Even so, when the tumor was opened, the blood pressure drop that most people don’t want to see appeared.
Seeing the patient’s blood pressure plummeting, the anesthesiologist shouted: Stop, lift the tumor slowly.
At this time, the surgeon also reacted, and quickly said: Good, good.
After seeing that the blood pressure is normal, the anesthesiologist asks the surgeon to try to lift the tumor slowly again.
This time, blood pressure also dropped, but not as much. Because, the anesthesiologist used vasoactive drugs in advance preventively.
Just as everyone was about to celebrate in their hearts, something unexpected happened: the normal end-tidal carbon dioxide waveform became distorted. The most important thing is that the value is also plummeting!
As a result, the blood oxygen saturation level, which is usually relatively firm, also fell.
Breathing problems are a big deal in surgical anesthesia. As a result, the anesthesiologist immediately stopped the operation, adjusted the breathing parameters immediately and asked the nurse to call for help.
However, no matter how hard you try, your blood oxygen will never come up, and your end-tidal carbon dioxide will be miserably low.
Within minutes, the operating room was full of people.
In the middle, the anesthesiology department is trying to pull the patient back.
However, no matter how hard they try, the patient is taking one step at a time.
During the rescue process, it was highly suspected that the patient had a pulmonary embolism.
Because the patient was bedridden for a long time, the preoperative examination did find that the blood flow in his lower extremities slowed down, and there was something suspected of blood clots deep inside.
However, when the patient’s family was advised to give the patient a superior vena cava filter, the family refused.
Explain: vena cava filter is an effective means to prevent the fall of deep vein thrombosis in the lower extremity and lead to complications such as pulmonary embolism, but because it is invasive and requires a certain cost, it is not accepted. high.
However, the fact has already happened, there is no regret medicine, but the best way to rescue.
During the rescue, the anesthesiology department dispatched personnel to communicate with the family about the rescue.
When it was said that the patient needed to be admitted to the intensive care unit for further treatment after stabilization, the patient asked with bitter red eyes: How much?
Be a doctorAfter saying “less to say more than 100,000”, the family members who were silent for a moment said: “Cure! The child’s father’s life is not easy.
The family’s remarks made the doctor feel a little relieved. If the patient’s family does not cooperate with the treatment, this is the most troublesome.
However, the cooperation of the patient’s family made the doctor a little difficult: because if the tumor can be recovered after being removed, it will be worthwhile to save it no matter what.
However, this tumor is malignant. This operation is only a tumor reduction operation.
In other words, this surgery is not a cure. However, the tumor was so large that it affected the patient’s normal eating, and even had a certain intestinal obstruction.
Weigh the patient’s future costs and look at the life-and-death patients on the operating table. The doctor comforted the family and said: It can be seen that your family is not rich. If the disease can be cured this time, I think it makes sense to go bankrupt. However, his disease is incurable, we are just helping him prolong his life. Therefore, we recommend that you do what you can.
And then said: If people and money are empty, maybe not what he wants to see, right? Of course, we are not giving up rescue, we will also actively provide necessary support means. Assuming his circulation stabilizes and his breathing improves, let’s move on to the next step.
Actually, there is nothing wrong with this suggestion. The hospital is not without the ability to treat. However, no matter how severe the pulmonary embolism is, if the extracorporeal membrane is put on the lungs in time, people can basically stay.
However, that would cost thousands of dollars a day. How many families can survive? If there is a meaningful rescue, we will resist. Resist the past, people are there, and money can be earned back. However, this patient has reached an advanced stage.
Sometimes healing, often helping. This may be the greatest help for him~
[Warm reminder] Please pay attention, here are a lot of professional medical science, to reveal the secrets of surgical anesthesia for you~