"Does director Peng know about the latest technology of stellate ganglion block anesthesia?" Wu mianwen asked.


    "..." Peng Peng was stunned.


    The latest technology? What''s that? Peng Peng subconsciously shook his head.


    "It''s not the latest, but it''s a little skill. I think it''s quite practical," Wu Mian said.


    "Mr. Wu, please speak." Peng Peng repressed his curiosity and said.


    "Let''s talk about the problem first. Technology can''t be learned in a day." Wu Mian continued. "Just looking at your expression, I feel that the process of blocking anesthesia... Wasn''t very smooth at first, was it?"


    "Well." Peng Peng didn''t hold his head in shame and nodded directly to admit, "there was no problem with the patient''s preoperative physical examination. I thought block anesthesia would be completed soon. But when I did stellate ganglion anesthesia, I tried it three times. There was bleeding in the first two times, and there was no blood until the third time."


    "A small amount of blood was withdrawn during the first two injections. After giving up the continuous injection of drugs, the injection was deeper at the third injection than the first two.


    When the needle tip touches the bone, I heard you say that the needle did not withdraw. It is estimated that the left hand is unstable and the needle tip continues to slide a little, resulting in too deep needle entry. Although there is no blood and cerebrospinal fluid, the needle tip is too tight, and there may be no blood during back extraction, so the possibility of entering the blood vessel by mistake cannot be ruled out. "


    Wu Mian looks back on director Peng''s previous operation. The more he listens, the more surprised he is. How can he see with his own eyes... No, he won''t see that the tip of the needle touches the bone when he operates without withdrawing the needle.


    It''s like walking through teacher Wu and telling yourself the wrong process before. But also their own hazy awareness, uncertain operation process.


    For a moment, Peng Peng felt split and exploded directly.


    He looked at Wu Mian in a daze. How did Mr. Wu know about the most private thing in the operation?


    "Ha ha, don''t be surprised." Wu Mian said with a smile, "I just infer according to the normal guess. Generally speaking, the just situation will occur when the anesthetic is injected into the vertebral artery. This is a matter of high probability."


    "There is a saying that happy life is the same, but unhappy life has its own misfortune. Our operation is similar.


    Just because everyone''s anatomical structure is different, every success may be a little different, but most of the failure cases are the same. "


    Wu Mian looked at Peng Peng with a smile on his face. He seemed to be lecturing students, but he was not too strict.


    "Miss Wu, you''re really good." Peng Peng praised dryly. In fact, he wasn''t sure what Wu Mian was talking about, but it was always right to say two good words.


    "In the horizontal section of the 7th cervical vertebra, the vertebral artery has not yet entered the transverse foramen, and it is close to the stellate ganglion, which may be the anatomical factor for the puncture to enter the vertebral artery by mistake. I believe you have paid great attention to it, but the problem will still occur."


    "To avoid... It''s impossible to avoid completely. After endotracheal intubation, there should be at least one set of standby." Wu Mian said, "another is stellate ganglion anesthesia under ultrasound guidance."


    "Ultrasound? It''s not very easy to use."


    "In the past, neither technology nor machines passed the test," Wu Mian said with a smile. "The previous two generations of B-ultrasound machines have been able to see the diffusion of local anesthetic drugs during injection."


    “……”


    Peng Peng and Zhang Zimo were stunned.


    The blood vessels of carotid artery and vertebral artery are relatively thick. It''s better to say if the blood flow can be seen by bedside B-ultrasound. Can B-ultrasound see the penetration of local anesthetic drugs?


    Mr. Wu, are you sure you''re not kidding?


    "Ultrasound guided direct vision block is safer and more reliable than the traditional block method located by palpation of transverse process. It can not only avoid vascular injury and accidental entry into blood vessels, but also reduce the dosage of local anesthetics."


    "The traditional method requires 8 ~ 10ml of 1% lidocaine and 2 ~ 3ml under ultrasound guidance. The effect is faster than the traditional block method. The dosage is small and safer."


    Wu Mian finished his words and smiled at director Peng.


    "Wu... Teacher, is your technology difficult?" director Peng stammered.


    The moment Wu Mian finished, Peng Peng felt that his voice was dry and his speech began to be awkward.


    "You want to learn? I''ll teach you." Wu Mian smiled.


    "Really?!"


    Peng Peng realized the benefits of this matter even earlier than Zhang Zimo and director Qian. After all, he is an old driver.


    Mr. Wu Mian said that this technology is not only safer and more reliable. If you can use B-ultrasound to locate and supervise, you can get out and take several apprentices.


    Before and during the operation, all kinds of operations are handled by people. They only need to take the B-ultrasound probe as guidance. Now I am busy until seven or eight o''clock in the evening, and the amount of work done by one person is still limited.


    And the key point is that Peng Peng doesn''t want to give up.


    It often happens that the old director is elevated, so Peng Peng would rather work late every day than do the things of church apprentices and starving master.


    But with new technology, things are completely different! In Peng Peng''s mind, a new version of the future has been outlined.


    If there is always B-ultrasound positioning during the operation, it is equivalent to the most difficult blind puncture. This step is omitted. He is responsible for guiding the puncture, and the young doctor is responsible for manual puncture.


    It can not only effectively and safely improve the number of treated patients, but also master the upstream core technology!


    As he gets older and older, patients accumulate more and more. Peng Peng also feels that he is unable to do what he wants recently.


    People have to serve the old. This inability is scattered around life from home to work.


    But once the role changes... Peng Peng suddenly feels that his eyes are suddenly open and a blue ocean is waiting for him!


    Wu Mian just smiled and looked at director Peng''s unpredictable expression, smiling without saying anything.


    Peng Peng was very excited at the thought.


    "Mr. Wu, the technology you said..."


    "The technology is very simple, mainly to distinguish the blood vessels and nerves. As for the infiltration of narcotic drugs, to tell the truth, you need to accumulate at least 10000 clinical operations before you can preliminarily master it," Wu Mian said.


    "That''s OK!" Peng Peng said, "Miss Wu, when do you have time?"


    Zhang Zimo glared at Peng Peng. It was impolite.


    Peng Peng was completely unaware of his rudeness and looked at Wu Mian excitedly.


    "Don''t worry. You should first get familiar with B-ultrasound." Wu Mian smiled. "First of all, you should understand how the frequency of linear array probe is defined as 9 ~ 13mhz, and then how to swing the probe direction at 30 ° ~ 45 ° to the sagittal plane of the neck. We''ll contact you at any time if you do well in these basic skills."


    According to Wu Mian, Peng Peng''s head is big.


    He knew that the probe of B-ultrasound seemed to be a high-frequency linear array probe, but although Mr. Wu simply said, would he have a deeper meaning?


    Is it difficult to dismantle the B-ultrasound machine and start from the most basic?