Seeing Zhao Heng's serious expression, Xiaohong and her husband also began to feel uneasy.

The couple looked at Zhao Heng eagerly, afraid he would say something like they couldn't administer anesthesia.

"Doctor... Can my wife be anesthetized in her condition?"

Xiaohong's husband asked nervously, stammering slightly.

"Anesthesia is possible, but we need to devise a comprehensive anesthesia plan, which will take some time."

Zhao Heng pondered for a moment before speaking slowly.

Administering anesthesia to this extremely obese patient presents numerous challenges.

Firstly, due to her excessive obesity, the patient's blood pressure is high, and her heart is under significant strain. Moreover, Zhao Heng observed that even at rest, the patient's breathing is not smooth.

This means that, during preoperative anesthesia, muscle relaxants cannot be used in excess, or it will suppress the patient's breathing.

Secondly, there is the issue of needle puncture.

According to Zhao Heng's observation, the thickness of the patient's back fat layer undoubtedly exceeds that of the puncture needle.

For average individuals, the fat thickness is 4-5cm, and for obese individuals, it's 6-7cm. However, this extremely obese patient has at least 10cm of fat, while a regular anesthesia needle is only 8.5cm long.

This means that not only is it difficult to find the puncture site, but the excessively thick fat layer may also result in the puncture needle failing to penetrate the fat to reach the epidural space.

"Thank you, thank you, doctor."

Upon hearing Zhao Heng say anesthesia was possible, Xiaohong and her husband felt a huge sense of relief and spoke excitedly.

This child embodies the couple's lifetime of hope.

"Take good care of yourself."

Zhao Heng nodded as he spoke.

He clearly saw the couple's excitement.

Soon, Zhao Heng and He Wei left the ward and returned to the office.

He Wei poured a cup of water for Zhao Heng, then slowly said, "Actually, when this patient first came, we all advised against childbirth. With her obesity, her heart is under heavy stress, and childbirth could easily trigger heart disease. But this couple was very insistent, which is why I called Dr. Zhao for a consultation."

"Given the circumstances of this patient, pregnancy is extremely difficult, so it's understandable that they are so determined."

Zhao Heng nodded as he took a sip of water.

"Yes, it might very well be the only pregnancy in the patient's lifetime."

He Wei agreed wholeheartedly.

"As for the cesarean section, is it complicated?"

Zhao Heng pondered and asked He Wei.

Being an anesthetist isn't simple; you must thoroughly understand the patient before administering anesthesia.

"The fat layer on the patient's body surface is too thick and difficult to cut through, but that's not the biggest challenge. I'm worried that during surgery, the patient's heart won't be able to handle the stress of childbirth."

He Wei reflected and said.

This was also why she sought a consultation with Zhao Heng. Although the surgery is complex, He Wei, as a senior obstetrician at Eastern Hospital, believed she could manage it.

The most critical issues are the patient's cardiac load and anesthesia during surgery.

"Indeed, I observed that the patient struggles to breathe even at rest. If muscle relaxants are used during surgery, it could easily lead to respiratory failure. The most crucial point is the patient's back fat layer, which I estimate to exceed the length of the puncture needle."

Zhao Heng continued to explain.

"So, Dr. Zhao, what about the patient's anesthesia?"

He Wei hesitated as she asked.

The challenges and risks are evident. If Zhao Heng chooses not to handle the patient's anesthesia, it would be understandable.

"Anesthesia is feasible, but we need a detailed anesthesia plan. In the next couple of days, Dr. He, please request a portable ultrasound machine from the ultrasound department."

Zhao Heng seriously considered and then suggested.

"A portable ultrasound machine? What is it for? Have you found a solution to the issue of the patient's thick fat layer blocking the puncture?"

He Wei asked in confusion upon hearing Zhao Heng's suggestion.

"I just have an idea. Let me organize it, and I'll be back tomorrow."

Zhao Heng stated.

"Well, then I'll trouble you, Dr. Zhao."

He Wei responded politely.

Soon, Zhao Heng returned to the anesthesiology department's doctor office from the obstetrics department.

Upon entering the office, Xu Man Ni noticed Zhao Heng's serious expression and asked, "What's going on in the obstetrics department? Is there a complicated patient?"

"Yes, it's an obese patient weighing 300 pounds scheduled for anesthesia."

Zhao Heng replied.

"Ha? 300 pounds?"

Upon hearing this, both Xu Man Ni and Sun Li widened their eyes in surprise.

300 pounds—what kind of concept is that?

Typically, the average adult weighs about 130 to 140 pounds.

300 pounds is nearly the weight of two average adults.

Such obesity places enormous stress on the heart, which can be imagined.

"Indeed, the main issue is that the patient's back fat layer is at least 10cm thick, which likely exceeds the standard puncture needle length."

Zhao Heng said somewhat helplessly.

"This..."

Upon hearing this, Xu Man Ni and Sun Li didn't know what to say.

The standard puncture needle length is 8.5cm, taking into account the condition of obese patients, whereas a normal adult's abdominal fat thickness is usually only 3cm. Thus, a 10cm back fat layer is an incredibly exaggerated measurement.

"With such a thick fat layer, aside from the fact that a regular puncture needle can't pass through, it's also challenging to find body surface markers for the puncture due to the patient's obesity."

Xu Man Ni frowned and said.

Considering this extremely obese patient's condition, it is almost an anesthesia blind spot.

Just thinking about it, it's evident that not only are the body surface markers hard to find, but even the puncture needle can't go through, so how can anesthesia be administered?!

"For this patient, if anesthesia is necessary, blind puncture is the only option."

Sun Li suddenly suggested.

"Blind puncture? That's a technique you only hear about in legends..."

Upon hearing her best friend's words, Xu Man Ni smirked.

Blind puncture refers to performing punctures based purely on the doctor's extensive experience when body surface markers are undetectable.

This requires an extraordinarily experienced doctor and one who is extremely familiar with human anatomy.

Xu Man Ni had been working in the operating room for years, and she hadn't seen this legendary blind puncture method ever being executed.

"It's not entirely blind. Total blindness would be relying on luck. You can use a portable ultrasound to identify the inter-membrane cavity suitable for puncture. Once you mark this cavity, you can proceed with the puncture."

Zhao Heng contemplated before suggesting.

"Ha? The human brain isn't a computer, and an ultrasound isn't a camera; this isn't believable."

Xu Man Ni felt that Zhao Heng's suggestion seemed somewhat unrealistic.

Ultrasound images are not very intuitive and require the doctor to mentally reconstruct a three-dimensional image.

Even if reconstructed, marking the location and then puncturing through a thick fat layer to that precise point is an almost unimaginable challenge.

In Xu Man Ni's experience, no one has ever managed to do such a thing!

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