But the next moment, Xu Qiu's calm voice came. He asked calmly: "Laparotomy?" The director of the Department of Urology was taken aback and replied: "We definitely need to do laparotomy. Minimally invasive surgery cannot be performed because the diameter of the patient's pheochromocytoma is too large. Moreover, a combined cesarean section surgery was required, and the tumor was removed together with laparotomy. " Xu Qiu nodded: "I can do it." "Yes? What are you doing?" The director of the Department of Urology was a little in disbelief. Resection of pheochromocytoma is fraught with danger! Once a mistake is made, no matter how talented the surgeon is, he cannot recover it. You can only rely on anesthesiologists to stabilize your blood pressure!
It can even be said that in this operation, the surgeon is secondary and the anesthesiologist is the real protagonist. unless-- The surgeon can perfectly peel off the tumor without leaking even a trace of catecholamines! But that kind of difficulty... not even the director of urology can do it! "Xu Qiu, how about you start with circumcision?" The director of the Department of Urology found a reason to refuse. Xu Qiu glanced at the mission. General tasks: Carve three scar dragons. Difficult task: perform a perfect operation (no accidents, critical situations, etc. during the operation) He thought about it and chose the difficult task. In the face of a master's degree in resection of pheochromocytoma, he was the most confident candidate to ensure that Li Qianqian and the fetus survived from the stage. "No, let's start with the removal of pheochromocytoma." Xu Qiu's voice was calm and confident. … Xu Qiu's reputation is too great. So, when he took the initiative to perform the surgery, Director Hu, Director of Anesthesia, etc. all chose to believe Xu Qiu even though the Director of Urology Department disagreed! Finally, the surgical plan was finally agreed upon. Because pheochromocytoma takes a long time, Therefore, the cesarean section was performed first. After the fetus was removed, Xu Qiu and the urology team removed the pheochromocytoma. The operation time was set at 4:30 pm.
There is still some time before the operation starts. Xu Qiu stayed in the conference room and began to confirm further details of the operation with the anesthesiology department, nursing team, and urology team. The expression of the director of the urology department also changed from confusion at the beginning to shock later. He didn't expect Xu Qiu to be so professional! In controlling many surgical details, he is even stricter than the director! This doesn't look like an outsider... "Xu Qiu, did you eat a urology expert alive?" the director of the urology department couldn't help but ask. … at the same time. Li Qianqian is also preparing urgent techniques. Routine preoperative examinations, such as electrocardiogram, three routine tests, liver and kidney function, electrolytes, four items of coagulation, seven items of blood transfusion, etc... Targeted terazosin reduces blood pressure and expands volume... However, the blood pressure reducing effect is not good. In the end, it was barely controlled at around 155/100, but it finally reached the surgical standard. In addition, this major surgery under general anesthesia requires the signature of the next of kin. Although Li Qianqian was absolutely unwilling, she still called her parents. At around three o'clock in the afternoon, her parents had already rushed over. They haven't figured out why their daughter suddenly became pregnant and expected to give birth. I finished the pre-operative conversation in a hurry and signed the informed consent form for the surgery with a panicked look on my face. … Half past four in the afternoon. The surgery started on time! Xu Qiu and the director of the Department of Urology entered the operating room one after another. The patient's preoperative blood pressure: 150/95mmHg, HR 109 beats/min, and SpO2 100% during oxygen inhalation. Afterwards, two peripheral veins were opened, and 1 mg of midazolam and 5 μg of sufentanil were administered. After local anesthesia is completed, Combined with B-ultrasound guidance, the FloTrac sensor was connected to the left radial artery puncture and catheterization and the pressure sensor was connected to the right internal jugular vein puncture and catheterization end. "Emergency drugs are fully prepared, and blood pressure and antihypertensive drugs are connected to the deep venous channel in two ways." The anesthesia director said, coordinating the overall situation.
Xu Qiu nodded. "Start induction of anesthesia." The other two anesthesiologists concentrated their attention and immediately used 2 mg of midazolam, 25 μg of sufentanil, 20 mg of etomidate, and 50 mg of rocuronium for induction! "Intubation completed!" After the words fell, the drugs were changed again to propofol, remifentanil, cisatracurium and dexmedetomidine combined with sevoflurane! … With the anesthesia completed, the surgery officially begins! Director Hu from the Department of Obstetrics and Gynecology came on stage and performed the cesarean section himself. despite this, During the process of removing the fetus, she still inevitably squeezed the abdominal cavity. boom! At this moment, the patient's blood pressure called the alarm and immediately soared to around 190/110, and his heart rate also reached 120! Anesthesiologist 1 stared at the blood pressure, and at this moment he immediately shouted: "Lower the blood pressure!" Anesthesiologist 2 immediately injected mg of phentolamine intravenously. In an instant, my blood pressure dropped and slowly stabilized back to around 133/74. The director of anesthesia said: "Continue, inject nitroglycerin into the intravenous pump, units per minute!" During the operation, There were a few more blood pressure spikes. The anesthesiologists were so shocked that their backs were wet. at the same time, The entire surgical team became nervous. Even cesarean section has brought the patient to the edge of critical illness several times. The next five hours of pheochromocytoma removal must be so dangerous! ! … finally, Under the huge pressure of the operation, a baby girl was successfully delivered by cesarean section in the 20th minute. The loud cry echoed in the silent operating room. Everyone's face unconsciously showed a smile.
After evaluation: The fetal Apgar score was 9 points. This means that the child is relatively normal and can basically survive as long as there are no accidents in the care. However, before everyone had time to be happy- Suddenly, the patient's blood pressure soared again! In the blink of an eye, it climbed to 180/110. "Intravenous injection of fentanyl + droperidol 5mg!" "Intravenous pump adjustment of sodium nitroprusside per minute!" "Esmolol 300mg/h!" The three anesthesiologists were highly focused and finally stabilized the blood pressure again. After Director Hu asked Li Xue to take the child away, he was slightly startled and immediately cast his eyes on Xu Qiu. "It's your turn..." "Okay." Xu Qiu's voice was very calm. Everyone was stunned for a moment. How could he be so calm? At this time On the operating table, the patient turned to the right side lying position. Xu Qiu, the surgeon, had a calm expression. With the help of his ability, Xu Qiu became calmer during such a thrilling operation. He opened a new operating channel along the cesarean section incision. The director of urology was still a little worried. After careful consideration, he said, "Xu Qiu, let me do it..." But before he finished speaking, Xu Qiu had already opened the incision. When he saw the tumor outside the adrenal gland, the director's face changed drastically and his voice stopped abruptly.