top student at medical school

Chapter 382 Limits and Ambitions (Second Update, Please Subscribe)
Sensorimotor separation is a colloquial description.

Du Yuanxian's expression actually originates from a clinical disease: dissociative motor and sensory disorders.

Dissociative motor and sensory disorders are a neurological condition characterized by the loss or impairment of motor or sensory function that cannot be explained by physiological or anatomical principles. This disorder may originate from damage to the brainstem, spinal cord, or peripheral nerves.

This disease inspired anesthesiologists, leading to the development of dissociative anesthesia and dissociative blockade in the course of research.

"Separation anesthesia" has no special clinical applicability and lacks clinical practical value.

"Dissociation block" refers to the variation in the sensitivity of local anesthetics with the axonal diameter of nerve fibers, the presence or absence of myelin sheaths, nerve function, and basic discharge frequency, which can even lead to the separation of motor and sensory nerves. The most common example is "walking epidural analgesia," in addition to which peripheral nerve blocks are widely practiced.

This is currently one of the most advanced techniques in anesthesiology.

Naturally, Du Yuanxian can also perform this technique during epidural analgesia, as it is a demonstration of an anesthesiologist's skill.

The reason it has such power is mainly due to its neuroanatomical composition.

In terms of distribution, nerves are divided into the central nervous system and the peripheral nervous system.

The peripheral nervous system includes the somatic nervous system, specifically the somatic sensory nerves and somatic motor nerves.

Yes, sensory nerves and motor nerves can be different branches. As long as the sensory nerve branch can be found and anesthetized, the patient's motor function can be preserved, such as "walking epidural analgesia".

However, the most researched and cutting-edge anesthesia methods in the anesthesiology department are currently epidural and major nerve blocks. As for sensory-motor dissociation under local anesthesia...???
It is theoretically possible, but how could anesthesiologists be so familiar with anatomical structures?

Under local anesthesia, reaching this stage requires not only an exceptionally thorough understanding of the nerve's course and anatomical structure, but also ensuring the puncture needle reaches the critical location, and then anesthetizing the senses while preserving motor function.

In this way, Mizi can complete a 'dialogue' with the surgeon while being painless, communicate in real time, observe motor function in real time, and check whether the sutures are done well in real time.
Fang Ziye glanced at Du Yuanxi, ignored him, stared at him for three seconds, and then gave him a warning to shut up.

He looked down and tapped Mi Qi's elbow: "That's enough, don't move! Functional rehabilitation should be done gradually."

Then he looked at Du Yuanxian again: "Local anesthetic, thank you, Professor Du!"

Fang Ziye's tone was stiff, using the simplest language to express the current situation.

If Fang Ziye were in the audience, he could easily discuss things with Du Yuanxian for an hour, but now Fang Ziye is the chief surgeon, and the chief surgeon is the main person in charge of the battlefield. Unrelated personnel, please shut up!

Any act that disrupts the surgeon's operation is shameful and unacceptable.

Does Fang Ziye really want to step down and have eight hundred rounds of academic discussions with you, Du Yuanxian, while Mi Qi just lies here waiting?

"Okay! Here you go!" Du Yuanxian is a professor, a senior professor of anesthesiology, so he is naturally well-mannered.

If Fang Ziye's actions hadn't been so shocking, he wouldn't have been able to resist interrupting.

Sensorimotor dissociation under local anesthesia—this topic, this research direction, is just so damn attractive...

Fang Ziye then looked at Lan Tianluo: "This time it refers to the deep flexor tendon, the diameter of which is approximately..."

As Fang Ziye spoke, Liu Huanglong cautiously replied, "No need to make an appointment, we have a ruler that can measure the circumference of the axis!"

Fang Ziye nodded upon hearing this, and then made Liu Huanglong and Professor Ni Yaoping feel involved as well.

After measuring the circumference, the two also measured the distance between the tendon and the skin, and reported it to Lan Tianluo.

Lan Tianlu quickly typed a few keystrokes and reported the relevant data back to Fang Ziye, then cautiously said, "This data is not detailed enough. Is it only anesthetizing the sensory nerve branch or sensory nerve surface?"

"The data isn't precise, but we can work backwards to deduce an index later..."

Fang Ziye thought Lan Tianluo was going to say something else, but when he heard it was about reverse deduction of the index, he lost interest and immediately started local anesthesia and continued suturing...

Naturally, during the re-suturing process, Fang Ziye praised, "Teacher Liu, you sutured the nerve so well. The local potential must be very active, and the alignment is excellent!"

Liu Huanglong nodded and gestured, "Ziye, we can discuss this issue later. You go ahead and stitch up the wound to finish this surgery."

"If our hemiarthroplasty can preserve 90% of the patient's hand function, no, only 80%..."

After Liu Huanglong finished speaking, he swallowed and looked at Professor Ni Yaoping next door.

Ni Yaoping's breathing quickened for a moment, his voice low: "Ziye, Huanglong, come to our hand surgery department, this is another peak..."

Ni Yaoping has discovered another talent.

Every time Ni Yaoping sees Fang Ziye and Liu Huanglong, he feels uneasy!

Damn it, these two are so close to hand surgery, if they joined forces, they could have created a masterpiece.

Liu Huanglong did not reply, but Fang Ziye seemed to have some energy left while suturing.

Fang Ziye felt relieved because of the high quality of the previous tendon suture: "Professor Ni, the pinnacle of hand surgery exists, but we cannot ignore the wilderness because of that."

"If the damage is severed but 30 percent of its function can be preserved, it will become a new mountain."

"Perhaps, in the current situation, what patients need more is to build another peak, rather than to elevate the existing peak."

Faced with Fang Ziye's polite refusal, Ni Yaoping's mood gradually calmed down.

From a researcher's perspective, the significance of establishing a peak and elevating a peak are essentially the same.

But this is of academic significance.

From a sociological perspective, what patients need is more hope, not to expand that hope further. Ideally, they could have both; if not, they must choose one.

Fang Ziye, Ni Yaoping, and the other two continued suturing together. Du Yuanxian checked Mi Qi's vital signs and found them to be very stable, then slowly began to move towards Lan Tianluo.

Then, with a radiant smile and squinting eyes, she spoke in a voice like a madam: "Young man, would you be interested in developing your career in our anesthesiology department? You have an exceptionally high aptitude for anesthesiology."

Lan Tianluo is pretty arrogant now. He glanced at Du Yuanxian and said casually, "You can't afford the price."

Upon hearing this, Du Yuanxian's face stiffened, and he became angry: "Hey, if you dare to say it, I dare to give it to you."

“A small goal! I’ll think about it.” Lan Tianluo didn’t speak, so as not to disturb Fang Ziye’s stitching, and typed a message for Du Yuanxi to see.

"I..." Du Yuanxian was dumbfounded.

Does the Department of Anesthesiology at Zhongnan Hospital have a small goal for its annual gross revenue? Lan Tianluo is talking about a small goal right off the bat?

"Are you making fun of me?" Du Yuanxi's tone turned gloomy.

Lan Tianlu shook his head, tilted his head, and said in a low voice, "Teacher, why would I make fun of you? I have no grudges or entanglements with the anesthesiology department or with you, teacher. I'm just telling the truth."

"I've been staying here obediently. I'm a trauma surgery student. You were the one who started this joke with me, weren't you?"

Seeing Du Yuanxian's expression shift between light and dark, Lan Tianluo said, "It's not that the anesthesiology department is bad, but you can't say that the anesthesiology department is better than our trauma surgery department, can you?"

I thought to myself, "So what if you're a professor? I'm not afraid of you just because you're a professor."

They're not from the same system anyway!

I've done it before, professor.

Du Yuanxian would never dare to fall into the trap set by Lan Tianluo.

There are two reasons. First, this is a generalization, and anyone who dares to say such a thing will be drowned in spittle by orthopedic and trauma surgeons.

Secondly, it's the trauma surgery department, which has the highest rate of medical disputes involving limbs in the hospital, but it's also the safest department. A bunch of tall, strong, muscular men can't beat it!

However, Du Yuanxian soon became curious: "Wait, classmate, if you don't have time to develop in our anesthesiology department, why are you studying so much data?"

"You should have studied this long ago and even found a formula."

"I'm not doing this for my sister...!" Lan Tianluo said, and the anesthesia fell silent.

But the moment Lan Tianluo finished speaking, he looked at Fang Ziye and found that Fang Ziye had already turned to look at him. He immediately slapped his own face.

He looked at Du Yuanxi with annoyance: "What I research is none of your business!"

"Who stipulated that trauma surgeons cannot study the metabolic rate and metabolic time of anesthetic drugs? Did you stipulate it? Even if you did, it wouldn't matter."

Du Yuanxian was so rebuked that he began to question his existence.

If he remembered correctly, just before Lan Tianluo came in, Fang Ziye said that this was his junior brother, a current student. A student confronting a senior professor?
Good heavens, this hasn't happened in a hospital in so long, and it's actually happened to me?

Are there any coping strategies or references?

It seems not!
Du Yuanxian left feeling humiliated, glancing sheepishly at Lan Tianluo, who remained completely unfazed...

"Keep moving! Be careful with the range of motion, don't use too much force, it's not worth breaking the stitches." Fang Ziye said to Mi Qi after finishing the stitching.

Michi did as instructed.

Ni Yaoping and Liu Huanglong, who were standing next to him, both gasped in shock.

When Mi Qi moved to what Fang Ziye thought was the "limit," he was told to stop: "Stop, it's good that you can go this far. You can continue your rehabilitation training in the ward later."

"After suturing the two more tendons, we can suture the skin!"

"Teacher Du, local anesthetic, thank you..." Fang Ziye instructed Du Yuanxian, who had just suffered a setback.

Upon hearing this, Du Yuanxian composed himself and continued in a tone like a madam: "Here, Dr. Fang."

If there are no dumplings, there's soup; if there's no fruit, there's noodles.

While Lan Tianluo is undoubtedly a master at data processing, if Fang Ziye could be brought into the anesthesiology team, the anesthesiology department at Zhongnan Hospital would definitely be booming!

Time passed little by little.

After Fang Ziye finished suturing the tendon with the last stitch, he asked Mi Qi to move his fingers without waiting for Mi Qi to open his mouth.

Liu Huanglong then asked, "Ziye, do you think that the top layer of tendon suture, the ultimate suture, is like this?"

"Or... is it possible?"

Liu Huanglong's suturing skills haven't reached that level, so he doesn't know if there's any way to further improve them.

Liu Huanglong yearned for both pushing his limits and setting even higher goals. He looked at Fang Ziye, his heart pounding, awaiting the answer…

(End of this chapter)