Sleepless Doctor

Mrs. Topte suppressed the surprise in her heart, and felt that Wu Mian must have obtained the information from the Dean of the Provost David in advance. Otherwise, there is no way to explain the contents of the document in hand.

After 　　1'22″, the anesthesiologist felt that the induction of anesthesia was not ideal, and began to give another medicine.

　　 Fentanyl, 0.11mg, exactly as written in the document.

　　 Mrs. Topt frowned and looked at the file in her hand. The file did not open and turned to the page with the current time stamp, but she seemed to see the words written on it.

　　 "Wu, how did you know that the induction of anesthesia is not ideal and you have to give it again?" Mrs. Topt asked.

　　 "All anesthesiologists in Cambridge and London tend to be conservative, especially Mr. Winter, I think he will be there when I have the consultation."

　　 Mrs. Topte nodded.

"Dr. Winter must be afraid that Principal Topte will have a sudden allergic reaction, so the final plan must be conservative." Wu Mian said, "And Principal Stephen Topte was a football player when he was young, and his body was very good. This How can this kind of dose of induced anesthesia reach the desired level."

　　 "Are you guessing all of this?" Mrs. Topt asked.

"Madam, this is a basic judgment based on the patient's physical condition and my understanding of other anesthesiologists." Wu Mian said, "This is not magical or cool. In fact, there is a touch of sadness in my heart. ."

　　 Mrs. Topp knew what Wu Mian was going to say, she did not continue Wu Mian's words, but stared at the screen to watch the operation process.

　　 After another bolus injection of fentanyl, the induction of anesthesia was ideal, but the blood pressure decreased temporarily. Because this was mentioned in the document, Mrs. Topt was not particularly surprised.

　　 What surprised her was how Wu Mian predicted it.

　　 Wu Mian's explanation just now? Mrs. Topte did not fully understand. It was amazing, like a Danish fairy tale, only children would believe it.

　　 After a brief panic in the operating room, as the numbers on the monitor stabilized, the emotions of all the doctors and nurses also stabilized. After a symptomatic treatment, after waiting for a few minutes, the vital signs did not change significantly, and then proceeded to the next step.

　　 Anesthesia maintenance: propofol·h, remifentanil 0.45mg/h, cis-atracurium/h continuous pumping.

　　 is still the same as written in Wu Mian's file.

　　 Satisfied with the anesthesia, the operation officially started.

　　 Mayo Clinic's cardiac surgeon Steven Dadley brushed his hands and disinfected and stood in front of the operating table. He seemed to know that Wu Mian was watching him after monitoring. Dadley did not operate directly, but stared at the surveillance camera.

　　 Stephen Dedley stared at him tightly, as if he was looking at Wu Mian in the air. After 10 seconds, he raised his hand to his chest and raised his middle finger.

　　 Mrs. Topt saw this scene, her expression was slightly stagnant.

　　 The dispute and disagreement between Wu and Da Deli are so serious. If the operation is carried out according to Wu's imagination, what will he do?

　　 Just when Mrs. Topt was upset, Stephen Dadley made a gesture to the assistant and the operation began.

When the skin was cut, the anesthesiologist continued to give 0.2mg of fentanyl, and Dr. Dadley opened the skin to stop bleeding locally and bluntly separated to the position of the breastbone.

　　 The technique is clean and beautiful, and the speed is very fast. Mrs. Topte glanced at the time, and she vaguely remembered that the file given by Wu Mian since the opening of the stage seemed to start marking the time.

　　 It's just that she can't remember those little times.

　　Opened the file and turned to the page of the operation. Mrs. Topt suddenly saw that after the stage was opened, she was about to split her breastbone. Before splitting the breastbone, she was given 0.2mg of fentanyl and 5mg of cis-atracurium.

　　 Do you still have to take medication? She raised her head, just after 12 minutes in the upper left corner of the screen, Dadley took the sternum saw handed by the instrument nurse and began to split her sternum.

　　 The anesthetist's figure in the screen showed only one corner, and the words on the right screen immediately appeared-before splitting the breastbone, give fentanyl 0.2mg and cis-atracurium 5mg.

　　 Mrs. Topte was stunned. She suspected that she had read it wrong. How could Wu's prediction be so accurate! I looked at the file carefully again, and then went back to think about what I just saw. I was surprised and started to fear.

　　If you continue to follow Wu's prediction, the operation will be successful, but Stephen can't get out of the cardiopulmonary bypass at all. As soon as you are offline, you will have a weak heartbeat until your heart stops beating.

impossible! Mrs. Topte comforted herself.

　　 These are all Wu's guesses. At the beginning, the situation was relatively simple. He could guess the next situation based on the existing information. As the operation progresses further, every little detail may disrupt Wu's guess.

　　 This is the most reasonable judgment, Mrs. Topte thinks so.

　　 From splitting the breastbone to seeing the heart, Stephen Topte's blood pressure remained basically stable throughout the process, with a fluctuation range of ~65mmHg.

　　 After splitting the breastbone, Dr. Daedley waited for 1'22”. Seeing that Stephen Topt was in stable condition, he started the next operation.

　　 The cardiopulmonary bypass group was given 150 mg of heparin sodium immediately for heparinization.

　　 Start cardiopulmonary bypass, lower body temperature, Dr. Dadley used a modified Favaloro retractor to raise the free side of the sternum, and the operating table tilted to the opposite side of the surgeon.

　　Using a low-power electrosurgical knife, first fold the pleura behind the breastbone and gently move it downward along the pleural fascia and the parietal layer of the pleura to expose the internal mammary artery.

　　 Dade uses a titanium clip to clamp it ~ www.wuxiaspot.com ~ electrosurgical cut to stop bleeding. After the loose tissue of the reflexed pleura was swept away, he put the electrosurgical head at a 45° angle to start freeing the internal mammary artery, and freeing from the middle section to the lower section.

　　 Make a 3cm incision in the intrathoracic fascia inside the artery and vein. Dade uses fine forceps to clamp the edge of the intrathoracic fascia to expose the internal mammary artery.

　　 Then use the tip of an electric knife to gently free the internal mammary artery, internal mammary vein, fascia, lymph, and a little fatty tissue along the lower part of the chest wall.

　　 The operation was extremely delicate. Dade used the elasticity of the subcutaneous tissue to pull up the internal mammary artery, and the forceps never touched the artery.

　　 This is a surgical detail, an extremely important surgical detail.

　　 Because Principal Stephen Topt’s blood vessels are full of arterial plaques, the forceps may crush the plaques, which may cause a cerebral infarction.

　　 For those who can understand surgery, Dr. Dadley's surgery is extremely delicate, and it is already the world's peak surgical level.

　　 But Mrs. Topt was not in the mood to appreciate Dr. Daedley's surgical skills, no matter how perfect it performed.

　　 Mrs. Topt looked back and forth between the screen and the front. Every step of the operation of Dr. Dedley was clearly written in Wu Mian's file, and even the time spent on the operation was recorded.

　　 The operation went well, but Mrs. Topte, who was supposed to be in a relaxed mood, had no sense of relief. She held the document desperately, filled with an absurd feeling in her heart.

　　 All of this is under Wu's control, even if he didn't have surgery.