Chapter 801 Dexmedetomidine combined with butorphanol

"Dead person?" Xu Qiu was startled.

Bronchoscopy is a very routine operation that can be performed by interns as long as they have undergone the most basic training.

Of course, you must obtain relevant operating qualifications.

Not to mention the current clinical doctors, even before Xu Qiu joined, Linhai No. 1 Hospital was only a top three hospital in the city, and there had never been a serious accident involving a person's death during bronchoscopy.

This is not even an accident... A doctor who can even perform a bronchoscope to kill people is not much different from a butcher.

"Is there such a thing?" Xu Qiu asked.

These days, he is busy building medical forums and supervising the improvement of the reporting center. Apart from outpatient clinics and surgeries, he has no energy to pay attention to anything else.

"Hey, is it so simple... I didn't lie to you, Doctor Xu, look at it!"

Jiang Donger handed over the mobile phone.

Xu Qiu glanced at it with a startled expression.

The director of the Respiratory Department of the Third Hospital was jointly reported by seven doctors. The report materials included the medical records of two deceased patients. The deceased were both in the respiratory department director's group. In theory, the director of the respiratory department was directly connected and responsible.

However, after bronchoscopy was ordered, the daughter of the director of the respiratory department performed the operation on his behalf, resulting in the patient's death.

After the death of the first patient, the director of the respiratory department forced doctors in the same department to be scapegoats on the grounds that they were not allowed to be promoted. His daughter continued to work in the department without any punishment.

Two months later, the daughter of the department director, who had no operating qualifications, came into battle again, causing the death of the second patient...

Of course, these are only one-sided words in the report letter.

The incident itself is not very popular. It is only circulated in some melon-eating groups on the Internet. It is not even on the hot searches. It is not that Jiang Donger has frequently searched for information related to lung diseases in the past few days, and this news cannot be seen.

"I will verify this matter. You don't have to worry. Bronchoscopy is very safe. There has not been a single patient who died due to this examination in Baiyun Province." Xu Qiu comforted.

Jiang Donger curled her eyelashes, looked at Xu Qiu and said, "Can you do it for me?"

Xu Qiu paused and looked at the afternoon surgery schedule. A bronchoscopy could be inserted between the two surgeries... He nodded and said, "Okay."

Hearing this, Jiang Donger's panic calmed down, and a relaxed smile appeared on his face.

…

Bronchoscopy is not difficult. It is the most commonly used diagnostic examination in the respiratory department.

Most diseases of the lungs and airways, such as tumors, interstitial lung diseases, granulomatous diseases, and pulmonary infections, can be diagnosed with bronchoscopy.

Including pulmonary tuberculosis suspected by Jiang Donger, it can also be verified by bronchoscopy biopsy.

Traditional bronchoscopy is divided into two types, namely non-X-ray guidance and X-ray guidance.

But no matter which one it is, it will bring a lot of psychological pressure to the patient. After all, few people can watch a tube going straight into the lungs. During the examination, deep breathing is required to assist the penetration and removal of the bronchoscope. out……

Not only does it cause severe pain, but it also leaves many patients with psychological shadows.

But the good news is that with the development of medical technology, bronchoscopy is now basically painless.

In the afternoon, after finishing an operation.

Xu Qiu glanced at the time and asked, "Are the bronchoscopy patients ready?"

After a bronchoscopy, you must not eat or drink for at least six hours and four hours.

Jiang Donger already has experience. She came to the clinic hungry this morning.

The main thing to control is drinking water... She has been told not to drink water since the outpatient visit.

In addition, chest CT, blood routine, coagulation function, liver and kidney function, pre-transfusion routine and electrocardiogram examinations are also completed.

Shi Lian said: "Everything is ready!"

Xu Qiu nodded and came to the ward to reassure Jiang Donger. After a brief conversation with his family, he went to the operating room.

He glanced at the configuration.

Instruments include electronic bronchoscopes, ECG monitors and dual-channel microinjection pumps.

The drugs chosen are lidocaine hydrochloride injection, dexmedetomidine hydrochloride injection and butorphanol tartrate injection.

Jiang Donger was very flustered on the operating bed.

However, seeing Xu Qiu busy beside her with a serious face, she still felt full of security.

"Nasal cannula for oxygen..."

"Liquid channel..."

"G……"

Xu Qiu proceeded in an orderly manner. After opening the intravenous fluid channel, he used an ECG monitor to monitor the patient's heart rate, oxygen saturation, and mean arterial pressure.

"Don't you need lidocaine?" Shi Lian was a little surprised.

For painless bronchoscopy, the guideline recommends injecting 5 ml of 2% lidocaine into the trachea for local anesthesia, then injecting 10 ml of normal saline intravenously, and then using a microsyringe pump to maintain the physiological flow of 10 ml per hour. Brine pumping speed until the end of the inspection...

But Xu Qiu's operation is obviously different.

Even the medicine he prepared was different.

Lidocaine was used before Jiang Donger entered the operating room. He asked the patient to atomize lidocaine for ten minutes.

At this time, dexmedetomidine was chosen.

Xu Qiu shook his head: "Dexmedetomidine is more effective."

He used a microsyringe pump to inject dexmedetomidine. After reaching the loading dose, he diluted butorphanol at a dose of fifteen micrograms per kilogram to ten milliliters and injected it slowly intravenously.

After doing all this, while waiting for anesthesia, Xu Qiu said: "Dexmedetomidine combined with butorphanol has a safer and more satisfactory analgesic and sedative effect, and the incidence of adverse reactions is lower."

"Where did you get this?" Shi Lian was surprised.

She had never seen Xu Qiu do relevant research.

Bronchoscopy is a minor first-level surgery, usually performed by doctors of Shi Lian's level. If Xu Qiu had not had an interval between surgeries this time, Jiang Dong'er would not have been able to schedule it.

Why did he suddenly come up with such a surprising conclusion?

Xu Qiu casually said: "The latest results I saw recently in a domestic journal, "The Application Effect of Dexmedetomidine Combined with Butorphanol in Painless Bronchoscopy", which explains in detail the advantages of dexmedetomidine combined with butorphanol."

If it is said that the improvement of anesthesia level has eliminated traditional bronchoscopy and painless bronchoscopy has been completely popularized.

Then, dexmedetomidine combined with butorphanol is enough to eliminate lidocaine used in painless examinations.

The former can ensure that the patient maintains more stable hemodynamics under anesthesia, and is less likely to suffer from respiratory depression, which greatly improves safety.

"It turns out to be like this..." Shi Lian was shocked.

How busy is the teacher every day? Where did he find time to look at the latest results?

Thinking of myself, I have done bronchoscopy many times, but I didn't even notice that such an important conclusion has emerged in this field... Shi Lian suddenly felt a little ashamed.