Coming out of the operating room, Zhao Heng quickly arrived at the Digestive Surgery Department and entered the office. The attending physician, Wei Tong, who had been sitting, immediately stood up when he saw Zhao Heng enter.

At Eastern Hospital, the biggest news and hot topic recently is the surgical equipment technician Zhao Heng, who has risen to prominence rapidly. He passed the anesthesiologist certification with a speed that caught everyone off guard and somehow became a formal anesthesiologist.

If it were just that, people would simply be envious. However, in the surgical department, all the surgeons who have worked with Zhao Heng in operations know that Zhao Heng's anesthesia skills are indeed outstanding.

Being both lucky and highly skilled commands much admiration.

Such a young talent, possessing both luck and skill, naturally draws attention from doctors in various surgical departments.

Wei Tong is no exception. As a surgeon, he deeply understands how crucial it is to have an excellent and reliable anesthesiologist in surgery.

An excellent and reliable anesthesiologist is the most solid support for the chief surgeon.

"Thank you for your trouble, Dr. Zhao."

Wei Tong said politely.

Now, Zhao Heng's status is different from before. If it were before, when Zhao Heng was still just a surgical equipment technician, calling him "Little Zhao" would have been fine.

But now, Zhao Heng's status is the same as his, already an official doctor at Eastern Hospital, so calling him "Little Zhao" is somewhat inappropriate, especially since he invited Zhao Heng for a consultation.

Interpersonal interactions can sometimes be very realistic. The differences in status and identity, and what attitude or title to use for different people, are often understood by everyone.

"No need for formalities, Teacher Wei. How is the patient's condition?"

Zhao Heng nodded. This change in address and attitude is something he has deeply experienced recently.

Previously, he was a surgical equipment technician. Although he worked diligently, he was not taken seriously, summoned and dismissed at will, never receiving the kind of respect he does now.

"The patient is an elderly female, seventy years old, admitted due to cholecystitis, acute pancreatitis, gallbladder sludge-like stones, and common bile duct stones. We are considering performing a cholecystectomy and common bile duct exploration to remove stones. The surgery is not very difficult, but the patient has a long history of hypertension, coronary heart disease, and diabetes, as well as chronic atrial fibrillation and a history of cerebral infarction."

Wei Tong quickly outlined the patient's complex situation.

Cholecystectomy and common bile duct exploration to remove stones are routine surgeries in the Digestive Surgery Department, with no high difficulty level. Most city hospitals can perform them, and for Eastern Hospital's experienced attending physician Wei Tong, it poses no problem at all.

However, the key lies in the anesthesia for this patient. It's known that elderly patients present high-risk anesthesia conditions due to their age, even without underlying diseases, because of the degenerative bodily functions in old age.

Furthermore, the seventy-year-old patient described by Wei Tong has hypertension, coronary heart disease, and chronic atrial fibrillation, which significantly increase the risk of anesthesia, potentially leading to severe complications during the procedure.

Therefore, Wei Tong reached out to Zhao Heng, who recently rose to prominence at Eastern Hospital and is known for handling complex anesthesia cases.

Previous instances of Zhao Heng's high-difficulty anesthesia during surgeries have already spread widely in the surgical department.

"Hypertension, coronary heart disease, and chronic atrial fibrillation..."

Upon hearing Wei Tong's description, Zhao Heng fell into deep thought. Indeed, this patient is a particularly challenging case.

It's known that anesthetic drugs inherently have the effect of numbing nerves and slowing heart rate and breathing. For a patient with chronic atrial fibrillation, the possibility of arrhythmia or even cardiac arrest during anesthesia becomes quite significant.

It's quite a predicament.

Zhao Heng slightly frowned, feeling a bit troubled.

"Dr. Zhao, the patient's condition really isn't suitable for delaying the surgery. Otherwise, I wouldn't have sought you out."

Seeing Zhao Heng frown, Wei Tong also felt he might be putting Zhao Heng in a difficult spot and couldn't help but express some regret.

In fact, he knew the patient's condition wasn't suitable for anesthesia, but as a physician, he still bravely sought Zhao Heng's expertise.

"It's alright. As doctors, we must consider the patient's well-being. Given the patient's condition, anesthesia does indeed present high difficulty, but it is not impossible."

Zhao Heng waved his hand, easing Wei Tong's slight embarrassment. As doctors, both prioritize the patient's interest, so there is no sense of challenge or not challenge here.

It's known that encountering complex cases in clinical practice is nothing out of the ordinary.

Sometimes, in critical situations, we must press on if the condition allows, and even if it doesn't, we must create conditions to make it possible!

"Thank you for your trouble, Dr. Zhao."

After hearing Zhao Heng's words, Wei Tong breathed a slight sigh of relief, as the patient's surgery could not be postponed any longer.

The patient's age already presents a significant risk. If surgery can't be performed, conservative treatment might lead to gallbladder perforation, causing severe infection. Moreover, the patient has acute pancreatitis, a condition that could become life-threatening at any moment.

"For this patient, I think we can use upper epidural block anesthesia. As for anesthesia drugs, we can opt for Ropivacaine and Bupivacaine, and within the spinal canal, we can use adrenaline with a concentration not exceeding 5μg/ml. This can extend the duration of the local anesthetic and minimize the dosage of systemic medication, avoiding impact on the patient's heart rhythm."

Zhao Heng thought seriously and, combining knowledge gained from Gao Jun and Professor Huang, provided a precise and detailed anesthesia plan.

Upper epidural anesthesia is generally used for postoperative pain relief.

But for this patient, choosing upper epidural anesthesia can reduce the dosage of general anesthetics, thereby significantly minimizing its impact on heart rate and lowering the likelihood of perioperative complications.

"Upper epidural anesthesia? Yes! Upper anesthesia can be used."

Upon hearing Zhao Heng's words, Wei Tong pondered briefly, his eyes brightening, and he agreed repeatedly.

For this patient, an average anesthesiologist would generally deem anesthesia unsuitable.

Because upper anesthesia involves manipulating the thoracic spine, and the upper and lower segments' spines resemble shingles with narrow gaps, making puncturing very challenging.

Moreover, this time the patient is a seventy-year-old elderly person. The senescent calcification in the supraspinal ligaments and the curvature of the spine increase the difficulty of puncturing.

The frail constitution and low tolerance of elderly patients demand immediate success in anesthesia, yet the difficulty of anesthesia puncture is escalated.

Under such unfavorable conditions, this anesthesia becomes exceedingly challenging. Generally, no anesthesiologist without extensive experience will take on this case.

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