307. "Intermediate Awakening Period"

Just as Payon left the surgical theater, Sedie left the auditorium and inexplicably became Kawi's assistant.

His mood was very complicated. He felt like a ball of string that had been messed up by a cat. It was a mess.

As the director of surgery at the Main Palace Hospital, you should never give up your position as chief surgeon unless it is for teaching purposes. This is the minimum professional self-esteem. If you cannot do this, there is no need to be the director of surgery.

But the problem is that the surgery completely fell into his blind spot of knowledge. Even if Kawei really offered it to him, he would not be able to take it. On the contrary, people like Kawei did not say anything or asked anything, and just took the position of the surgeon.

Of course, it is the best, and it can be regarded as giving him a step up.

If someone asked afterwards why he was not the chief surgeon, Cediyo would blame everything on his gentlemanly attitude.

If you succeed, you can say that you want to give opportunities to the Austrian doctors who come from afar, and you can also say that you are cultivating talented young people. If you fail, you can say that you are too gullible in Kawei's talent, and you are not strong enough in the selection.

No matter what, he can get some light.

But soon, the situation on the operating table changed, and his newly calmed mood became complicated again.

It felt like I had just balled up a ball of thread and the cat snatched it away before I could put it into the drawer. But this time the cat looked different, more like a tiger with its head down the mountain. The whole operation was also because of this

Things have risen to a whole new level, so new that it’s unbelievable.

"Surgical theatre." Sebasto's mind finally responded to the words, "Operating theatre? Are you operating on me?"

Maybe it's because Carvey's advice is very applicable to him, or maybe it's because he has regained his original intention for surgery, or he has confidence in drilling. In short, Sedillo is now back to his original self.

Kawei nodded and put down the ether mask.

Kawei spoke very quickly, but Shebasto seemed to understand: "My head hurts, I'm afraid."

"The surgical theater of the Main Palace Hospital." Kawei pulled out several ropes and began to tie his hands and feet. "I fell down at the masquerade party, broke my head and fainted. I have been sleeping until now."

In fact, the skull is still covering his head intact. No matter how he moves, except that the scalp will swing back and forth due to the lack of fixation measures, no other accidents will happen.

At this time, the door of the surgical theater was pushed open, and the nurse and Payon walked in together. The head tourniquet, rongeur, watering can and oral analgesic tablets and tincture were all in place.

"No, it should be in the warehouse."

But in the eyes of others, Kawei's reaction did not reflect this surprise, because he did not ask the nurse to find ether for re-anaesthesia immediately like other surgeons, but did the opposite and directly called his name.

: "Mr. Sebasto, Mr. Sebasto, wake up!"

"Oh hiss." Sebasto felt a headache and wanted to raise his hand to touch his head, but found that Kawei had quickly tied him to the operating table, "This is."

Sebasto looked at Kawi and Cediyo standing on both sides, savoring the smell of alcohol remaining in his mouth, and made the biggest decision in his life: "I accept it, please heal me!"

In any case, Shebasto's awakening is definitely great news.

This is because it is extremely difficult for Sebasto to remain calm while undergoing an awake craniotomy. After the skull is opened, violent physical resistance may further aggravate intracranial bleeding.

Suddenly, the wrist she was holding moved.

"Drill or not?"

After saying a few words, there was a response to the call. Shebasto began to move his hands, then his facial muscles, and then his eyelids.

Cediyo looked at Sebasto, who was about to wake up, and really couldn't understand this approach: "Dr. Carvey, don't you think that in this day and age, forcibly interrupting anesthesia is a very inhumane thing."

Kavi clarified Shebasto's light reflex and continued to shout: "Mr. Director, wake up, Mr. Director!"

The cutting of the wire saw is based on the hole in the skull. The hole at the temporal pole has been drilled. Now it is necessary to drill two more holes on the cutting line to facilitate the insertion of the wire saw under the skull.

"But I want to watch the leeches."

Cediyo can no longer remember the last time he practiced under the supervision of a chief surgeon, how many years ago it was.

".Drill."

"Well, I know." Kawei didn't understand what others meant at all, and continued to call his name, and even did not hesitate to use the name of a certain girl to shout and slap him on the face, "Sebasto! Mr. Director! Sarah

Miss Na brought brandy to see you, wake up!"

This is also an important reason why Kawei chose to have awake surgery at this time.

Even Sebasto, who had been on the front line in his early years, became a little uneasy when he heard these words. His hands and body reacted immediately, and he instinctively wanted to break free and leave the operating table, but the wounds fixed on both sides of his head

The headband and several straps told him that this was pointless.

The operation began to speed up. Kawei took care of Shebasto's mood while quickly drilling: "How do you feel now?"

Cediyo's mind was still stuck at the moment when he made the decision, still thinking about the feasibility of local anesthesia with ether and the significance of awake surgery. Kawei's question burst his thought bubble and made him think again.

Pull back to the surgery.

If Sebasto has been in an unstable state and shows no signs of calming down, he will immediately choose general anesthesia to maintain the basic operation of the operation.

"The pain of the operation only exists on the scalp. It is indeed inhumane to be awake now, but at least it is better than cutting off the hands and feet 20 years ago." Kawei asked the nurse to find ether, but the key thing was missing. "I don't have it either.

They say there is no anesthesia, but the method of anesthesia is different. By the way, is there a watering can here?"

"Don't be excited, don't be excited."

"How does it feel?"

Kawei didn't expect that he would become so sober. He realized that his impromptu idea was still too forced, and his "patience" had also reached the bottom.

The first person to notice the change was not Cedieu, but the nurse who had a blower on her feet and monitored her heart rate and breathing at all times. She put her right hand on Sebasto's wrist and watched the rise and fall of her chest and abdomen.

"I understand, I understand everything." Kawei held a hand drill in one hand and an ether mask in the other. "But the operation has been delayed for a long time, and the meninges that were just cut began to bleed out again. Please make a decision now."

"Oh." Shebasto didn't have a real feeling about the surgery. The only thing he felt now was a headache. "I feel some pain in my head. Can you help me take a look?"

Sebasto slowly shook his eyelids, only to feel that there was a hazy golden light curtain in front of him. The light made it difficult for him to open his eyes fully. His whole body was weak, and he couldn't move even if he wanted to, just like a machine that had been set up for more than ten years.

The old machine was replaced with a shovelful of coal.

"It really doesn't hurt much anymore." He looked at the scalp that was still dangling in front of his eyes, still hesitating whether to accept Kawei's suggestion. "To be honest, I have never heard of a craniotomy being performed while awake. This is

Everything happened too fast and suddenly."

"Don't worry, it's nothing serious." Kawei said with a smile, "It's just a protective measure to prevent you from moving around."

This is the skull! Below is the brain!

Hematoma compression of brain tissue caused by subdural hemorrhage often occurs hidden and progressively worsens. By the time it is discovered, it is already too late. Therefore, subdural hemorrhage is rarely seen in the waking period, because once coma occurs, it will only become more and more serious.

, couldn’t wake up at all.

The tourniquet was placed on Shebastow's head.【1】

"Let them secrete saliva slowly inside. You have half an hour to rest."

Theoretically, the intermediate awake period is only seen in epidural hematoma.

This is a great craniotomy!

"I remember that the skull has a double-layer structure. After breaking through the middle barrier, there is another layer underneath."

At first she didn't care too much. After all, it's very common for ether to fail. All she needed to do was add some anesthetic: "Dr. Kawei, the patient is about to wake up. I'm going to get ether now."

After hearing the news, Kavi was uncharacteristically surprised, as if he was a different person. He was still sitting on the chair, looking at Sebasto's motionless head, and pressed his eye sockets with his hands.

As for the so-called coma before, in fact, the orbital reflex, tendon reflex, and light reflex all exist, but the reaction is slow. These things are all human judgments, and they cannot be used as key evidence for a clear diagnosis.

This is definitely the best news for the entire operation. On the surface, it means that Shebasto has woken up from a coma. But if the interference of alcoholism is taken into account, whether it should really be labeled as coma beforehand?

It requires further consideration.

The orbital pressure reflex was very strong, not only frowning but also body swinging, which was much more obvious than when he first entered the hospital.

"Then we'll finish the third hole." Kawi relaxed his grip, looked at Cediyo beside him, and handed over the hand drill, "Professor, are you interested in playing one?"

Logically speaking, he shouldn't have taken over, not even the position of assistant. But who made him a surgeon? When his mind came to his senses, he had already tightened his grip on the drill handle, and he still couldn't bear it.

Live with the desire to try your hand.

Skull drilling is a basic operation in neurosurgery and is not very difficult. Especially since Kawei has done it three times before and Seddie has seen it three times, they already know the approximate thickness of Shebasto's skull.

"Where am I?"

"woke up?"

"I will soon spray ether on the scalp and skull as a local anesthesia." Kawei said, "The feeling in the scalp wound will definitely still be there, but it will be much more comfortable than now. At the same time, you can still stay awake. I'm here

When dealing with blood accumulation, you can also get timely feedback on your status."

"Yes, you must be careful when handling the lower bone plate." Kawei picked up the wire saw and the metal guide plate [2] and said, "Of course, don't pay too much attention to it. Stop it in time when you feel a breakthrough.

Just use your hands."

"The surgery site is on the head."

"this"

".Hmm. Uh-huh."

"Yes, Mr. Director."

The two nurses were performing their own duties, but when they asked Peon to get the equipment, they said that neither one of them would work. As a result, after only a few minutes, Kawei's face changed. The nurse complained, but the operation still had to go on.

, they must obey the deployment.

As for vomiting, which can be attributed to alcohol, incontinence and convulsions are common symptoms of intracranial hemorrhage compressing the frontal lobe. Urinary incontinence itself may also be overflow incontinence that occurs after a large amount of liquid intake, which Kawei cannot determine.
To be continued...