Great Doctor Ling Ran
chapter-785

Chapter 785: Work Done Through Experience

*Beep… Beep…*

The monitor in the operating theater made a monotonous noise like a duck with a hand around its throat quacking while acting like a loan shark

Su Jiafu obediently sat on a round stool. From time to time, he looked at the numbers on the display screen and then looked at his department director carrying out his tasks like a duck with a hand around its throat hiding from loan sharks.

“Take propofol with remifentanil. You can reduce the dosage of propofol, this can also shorten your postoperative recovery time…” as the department director of the Department of Anesthesiology administered anesthesia, he also chatted a little with Su Jiafu.

Ling Ran was used to have Su Jiafu as his anesthetist, and both of them were able to cooperate with each other. But if they wanted to improve the patient’s prognosis in all aspects, especially in reducing the recovery time, a good anesthetist would be very important.

Su Jiafu was a good anesthetist, but he was still not skilled enough. He could only ask for his senior doctors in the Department of Anesthesiology for help when he wanted to improve even further.

After consulting the Department of Anesthesiology, they put forward the most suitable anesthetic plans and adopted venous anesthesia.

When compared to the commonly used sevoflurane for inhalation anesthesia throughout the entire surgery, remifentanil, which was commonly used in total intravenous anesthesia, provided a faster recovery rate, had a shorter effect on the patient, and prevented accumulation of substances in the patient’s body. When compared with the two groups, the probability of postoperative dementia was lower when using total intravenous anesthesia.

Postoperative dementia was a common complication after general anesthesia. Once it appeared, the patients’ cognitive ability, attention span, and language ability may have short-term impediments, and a few people may even have long-term impediments.

Of course, the probability of long-term impediment was very low, and postoperative dementia mainly occurred in elderly patients. In addition, the higher the patients’ education level, the lower the probability of postoperative dementia.

With Chen Xiaowang’s working environment, short-term dementia may already be something that he could not bear with. Once the department director of the Department of Anesthesiology was called on by Huo Congjun, even though he was not afraid of Huo Congjun, he still did not want Huo Congjun to look down on him. Hence, he considered many aspects when he chose his anesthesia plan.

A person who was despised by Huo Congjun would usually be scolded if he did something wrong, and Huo Congjun would even rebuke him while he looked down on him. As the director of the Department of Anesthesiology, he naturally could not go through such suffering.

The department director had been checking if the data on the display screen was stable before he watched Su Jiafu fill in the forms on the computer. He then pointed to the dosage of various drugs and said, “Next time you do the same thing, you need to have an idea of what’s going on. Don’t just make calculations blindly. Take cisatracurium besylate as an example. When you use it during induction, you have to control the amount used. When it comes to dexmedetomidine, pay more attention, if you used too much, the patient will have hypotension, bradycardia…”

Su Jiafu listened obediently like a trained puppy.

For Su Jiafu, who was a resident doctor, it was a rare opportunity to get training from the department director.

The Department of Anesthesiology was busier than ordinary specialist departments. If the doctors in other departments had reached the level of department directors, they would have some spare time for conversations. However, the department director of the Department of Anesthesiology had to often work on the front line.

As the saying went, “There are minor surgeries, but no minor anesthesia.” Once the department director of the Department of Anesthesiology had to work, he had to do things conscientiously, and he could not relax. That was why the new people in the department every year would be ignored by the department director unless someone asked for help.

It could be said that the growth of a doctor could not escape from coincidence. Two resident doctors might join the hospital at the same time, but they might receive teachings from two different doctors at two different levels, and it was a very metaphysical thing. Most of the time, it was not about the novices’ performances, but also about the senior doctors’ attitude and how busy they were.

Su Jiafu did not have the chance to listen to the department director’s lecture before, but now that he had this opportunity, he was naturally extremely grateful for it.

Similarly, Lu Wenbin and Ma Yanlin who were before the operating table also performed the surgery seriously.

They could all see that Ling Ran’s approach was very different today.

Surgeons were very crude when they performed surgeries. The more professional the doctors were, the cruder they would be sometimes. It was like taking care of a child. The parents would be more patient and worried more about their firstborn. They would feel nervous when they turn over and worry if they would end up squashing their arms. However, the parents’ attitude toward their second and third child would be absolutely different.

When general surgeons did their first appendectomy or their first cholecystectomy, they were absolutely afraid of making mistakes, but of course, they would definitely make mistakes.

However, during their tenth or twentieth case, some crude and illegal actions formed from habit would begin to appear. During the hundredth case, surgeons not only would form their own routines but also form their own unique, crude methods. They would be like a semi-new driver who had driven a car for two years. They would drive with the ferocity of a tiger, but if anyone looked closely, they would notice that these drivers were driving blindly.

In comparison, Ling Ran always had strict requirements, but not to the point of nitpicking.

After all, human bodies were different. It would be meaningless to emphasize a unified value or to be fixated on certain boundary lines.

But it seemed that Ling Ran’s requirements today were unusually high.

Even the output frequency of the ultrasonic knife was constantly adjusted, causing Lu Wenbin and Ma Yanlin could not understand what was going on, even though they were amazed by it.

Ling Ran was still silent. To be honest, he already said what he wanted to say during the preoperative consultation. All the maneuvers he currently performed had already been tried and tested.

An ultrasonic knife was a kind of medical device which could cut and solidify things using high-frequency vibration. To some extent, this kind of knife, which could reach over fifty thousand Hz at its highest frequency was the kind of technology that exceeded human understanding.

The greater the power output, the stronger the cutting ability. The lower the power output, the weaker the cutting ability, but it would have a stronger ability to coagulate and stop bleeding.

When the same doctor, used an ultrasonic knife for surgery, he would be one-third faster than when he used an endotherm knife for the surgery, and the effect would be better.

Besides, when performing bleeding control, an ultrasonic knife would be able to control the bleeding in one second, but an endotherm knife would take five seconds.

Since the endotherm knife would have longer contact with the tissues during those extra four seconds, it would just end up causing more damage.

Therefore, Ling Ran had to choose the right frequency and time to finish cutting and coagulating the blood without damaging the tissues.

Even the angle of the titanium clips had been specially adjusted and tested using the Virtual Human.

When the abdomen was closed, the bile duct and other tissues would be packed together. With the natural peristalsis of the body, when the titanium clips were not placed well, it would be easy for complications to arise.

However, these were all events that had a low probability of happening. If Chen Xiaowang had not made his request, there was no need for Ling Ran to be so meticulous.

But from another point of view, it was his request that gave Ling Ran a framework for his entire idea and a goal.

There was no specific data in many aspects of clinical medicine. In certain aspects, the surgeons were required to lower the power output of the ultrasonic knife, but how low was low? In certain aspects, the surgeons were required to be careful when they placed the titanium clamps, but just what angle were they striving for? There was no formula.

The value of surgeons was often reflected in this.

Surgeons’ experiences were accumulated through countless surgeries and contemplation. They also had to follow the right steps and do the right things. Over time, the success rate would increase.

In comparison, the development of evidence-based medicine was still new. It was still impossible to search for evidence in every step of the surgery.

But it was still possible for the surgeon to treat a patient and become even better based on the framework he used on the patient.

Maybe it would not change the world, but it would make the world a more hopeful and better place.