麻醉概述----英文_精品文档PPT推荐.ppt

麻醉概述----英文_精品文档PPT推荐.ppt

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ANESTHESIOLOGYANESTHESIOLOGYPeiXuxingDepartmentofAnesthesiologyPeoplesHospitalofHenanProvinceContents1.Thehistoryofanesthesiology2.Thescopeofanesthesiology3.ClassificationofAnesthesia4.DefinitionofAnesthesia5.PreparingforanesthesiaTheHistoryofAnesthesiologyAnestheticpracticesdatefromancienttimesTheHistoryofAnesthesiologyModernanesthesiologybeganin1846-Etherwasusedasananestheticagentinhumans.WilliamT.G.Morton（1819-1868）TheHistoryofAnesthesiologyModerninhalationanestheticsweredevelopedfrom1950sto1960sIntravenousanesthesiafirstbeganin1872-Useofchoralhydrate.Fromthen,manyotherintravenousagentsweredeveloped.Musclerelaxantsresultedinevolutionofanesthesiology-Curare（箭毒）wasfirstlyusedin1942TheHistoryofAnesthesiologyTheoriginalofmodernlocalanesthesiawascreditedtouseofcocainein1884.Subarachnoidanesthesia-1898.Caudalepiduralanesthesia-1901.lumbarepiduralanesthesia-1921TheScopeofAnesthesiology1.Clinicalanesthesia2.Painmanagement3.First-aidandresuscitation4.Intensivecare8术前给药麻醉诱导麻醉维持呼吸管理呼吸管理气管插管气管插管控制呼吸控制呼吸辅助呼吸辅助呼吸循环管理循环管理麻醉深度麻醉深度容量容量血管活性药血管活性药苏醒麻醉恢复静脉诱导静脉诱导全凭静脉麻醉全凭静脉麻醉（TIVATIVA）拔管术后疼痛管理全身麻醉过程全身麻醉过程吸入诱导吸入诱导吸入麻醉吸入麻醉静吸静吸复合麻醉复合麻醉DefinitionofAnesthesiaAnesthesiaisalwaysdefinedbydrug-inducedchangesinbehaviororperception.Thecomponentsofgeneralanestheticstateincludeunconsciousness,amnesia（健忘）,analgesia（镇痛）,immobility,andattenuationofautonomicnervoussystemresponsestonoxiousstimulation.CourseofAnesthesiaAnesthesiainductionAnesthesiamaintenanceAnesthesiarecoveryClassificationofAnesthesiaGeneralanesthesiaInhalationanesthesiaIntravenousanesthesiaCombinedanesthesiaIntravenousVenous-inhalationIntrathecalblock-generalanesthesiaLocalanesthesiaTopicalanesthesiaInfiltrationanesthesiaNerveblockNerveplexusblockIntrathecalblock:

@#@Subarachnoidblock,epiduralblockandcaudalblockMonitoringDuringAnesthesiaTheCardiovascularSystemTheRespiratorySystemLiverandkidneyfunctionCentralnervesystemCoagulationfunctionPainManagementPostoperativeanalgesiaDeliveryanalgesiaAcuteandchronicpaincureCanceranalgesiaPreparingForAnesthesiaPreoperativevisitPreoperativeevaluation:

@#@History,physicalexamination,laboratoryevaluationPreoperativefastingCoexistingdiseasetherapyEquipmentpreparationPreoperativemedicationPurposesofthepreoperativevisit1.Establishrapportwiththepatient2.Obtainahistoryandperformaphysicalexaminations3.Orderaspecialinvestigations4.Assesstherisksofanesthesiaandsurgery5.InstitutepreoperativemanagementRoutinePreoperativeAnestheticEvaluationHistoryReviewoforgansystemclinicalexaminationLaboratoryEvaluationASAPhysicalStatusClassificationClassDefinition1Anormalhealthypatient.2Apatientwithmildsystemicdiseaseandnofunctionallimitation3Apatientwithmoderatetoseveresystemicdiseasethatresultsinsomefunctionallimitation4Apatientwithseveresystemicdiseasethatisaconstantthreattolifeandfunctionallyincapacitating5Amoribundpatientwhoisnotexpectedtosurvive24hourswithorwithoutsurgeryEIftheprocedureisanemergency,thephysicalstatusisfollowedby“E”PreoperativeFastingThetimeoffastingsolidismorethan12hours,andfluidismorethan4hours.Thetimeoffastingbreastmilkis8hoursinbaby.Ifnecessary,babyshouldbetransfused.CoexistingDiseaseTherapyCoexistingdiseasemayaffectoutcomeadverselyifnotunderoptimumcontrol.Thecoexistingdiseasemustbetreatedproperlybeforeanynonurgentsurgery.CoexistingdiseaseanddrugtreatmentmayinteractwithanesthesiaandsurgeryinseveralwaysCoexistingDiseaseTherapy1.Thecourseofthediseasemaybemodifiedbyanesthesiaorsurgery.2.Influencetheeffectsofanesthesia.3.Bothdiseaseanddrugtreatmentmayinfluencechoiceofanesthetictechnique.4.DrugtreatmentmaymodifythenormalcompensatoryphysiologicalresponsesChoiceofAnesthesiaFactorstochoiceaanesthetictechnique1.Patientcondition2.Surgerycategory3.Thetechnicalandtheoreticlevelofanesthetist4.Anesthetics5.AnesthesiaandmonitorequipmentEquipmentanddrugPreparationAnestheticmachine1.Electricalsupply2.Allessentialequipmentispresentandcorrectlyassembled3.Medicalgassupply4.Vaporizers5.Breathingsystem:

@#@VentilatorsEquipmentanddrugPreparationAncillaryEquipment1.laryngoscopes,intubationaids2.Facemasks,airways,trachealtubesandconnectors3.SuctionapparatusEquipmentanddrugPreparationMonitoringequipmentanddrug1.NIBP,SpO2,ECG,etc.2.Ephedrine,Atropine,etc3.AnestheticsPreoperativeMedicationGoalsforpharmacologicpremedication1.Sedationandhypnosis2.Analgesia3.Reducesecretions4.AttenuateautonomicnervoussystemresponsesThankYou!

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