麻醉概述----英文.ppt

麻醉概述----英文.ppt

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ANESTHESIOLOGY,PeiXuxingDepartmentofAnesthesiologyPeoplesHospitalofHenanProvince,Contents,ThehistoryofanesthesiologyThescopeofanesthesiologyClassificationofAnesthesiaDefinitionofAnesthesiaPreparingforanesthesia,TheHistoryofAnesthesiology,Anestheticpracticesdatefromancienttimes,TheHistoryofAnesthesiology,Modernanesthesiologybeganin1846-Etherwasusedasananestheticagentinhumans.,WilliamT.G.Morton（1819-1868）,TheHistoryofAnesthesiology,Moderninhalationanestheticsweredevelopedfrom1950sto1960sIntravenousanesthesiafirstbeganin1872-Useofchoralhydrate.Fromthen,manyotherintravenousagentsweredeveloped.Musclerelaxantsresultedinevolutionofanesthesiology-Curare（箭毒）wasfirstlyusedin1942,TheHistoryofAnesthesiology,Theoriginalofmodernlocalanesthesiawascreditedtouseofcocainein1884.Subarachnoidanesthesia-1898.Caudalepiduralanesthesia-1901.lumbarepiduralanesthesia-1921,TheScopeofAnesthesiology,1.Clinicalanesthesia2.Painmanagement3.First-aidandresuscitation4.Intensivecare,8,术前给药,麻醉诱导,麻醉维持,呼吸管理气管插管控制呼吸辅助呼吸,循环管理麻醉深度容量血管活性药,苏醒,麻醉恢复,静脉诱导,全凭静脉麻醉（TIVA）,拔管,术后疼痛管理,全身麻醉过程,吸入诱导,吸入麻醉,静吸复合麻醉,DefinitionofAnesthesia,Anesthesiaisalwaysdefinedbydrug-inducedchangesinbehaviororperception.Thecomponentsofgeneralanestheticstateincludeunconsciousness,amnesia（健忘）,analgesia（镇痛）,immobility,andattenuationofautonomicnervoussystemresponsestonoxiousstimulation.,CourseofAnesthesia,AnesthesiainductionAnesthesiamaintenanceAnesthesiarecovery,ClassificationofAnesthesia,GeneralanesthesiaInhalationanesthesiaIntravenousanesthesiaCombinedanesthesiaIntravenousVenous-inhalationIntrathecalblock-generalanesthesia,LocalanesthesiaTopicalanesthesiaInfiltrationanesthesiaNerveblockNerveplexusblockIntrathecalblock:

Subarachnoidblock,epiduralblockandcaudalblock,MonitoringDuringAnesthesia,TheCardiovascularSystemTheRespiratorySystemLiverandkidneyfunctionCentralnervesystemCoagulationfunction,PainManagement,PostoperativeanalgesiaDeliveryanalgesiaAcuteandchronicpaincureCanceranalgesia,PreparingForAnesthesia,PreoperativevisitPreoperativeevaluation:

History,physicalexamination,laboratoryevaluationPreoperativefastingCoexistingdiseasetherapyEquipmentpreparationPreoperativemedication,Purposesofthepreoperativevisit,EstablishrapportwiththepatientObtainahistoryandperformaphysicalexaminationsOrderaspecialinvestigationsAssesstherisksofanesthesiaandsurgeryInstitutepreoperativemanagement,RoutinePreoperativeAnestheticEvaluation,HistoryReviewoforgansystemclinicalexaminationLaboratoryEvaluation,ASAPhysicalStatusClassification,PreoperativeFasting,Thetimeoffastingsolidismorethan12hours,andfluidismorethan4hours.Thetimeoffastingbreastmilkis8hoursinbaby.Ifnecessary,babyshouldbetransfused.,CoexistingDiseaseTherapy,Coexistingdiseasemayaffectoutcomeadverselyifnotunderoptimumcontrol.Thecoexistingdiseasemustbetreatedproperlybeforeanynonurgentsurgery.Coexistingdiseaseanddrugtreatmentmayinteractwithanesthesiaandsurgeryinseveralways,CoexistingDiseaseTherapy,1.Thecourseofthediseasemaybemodifiedbyanesthesiaorsurgery.2.Influencetheeffectsofanesthesia.3.Bothdiseaseanddrugtreatmentmayinfluencechoiceofanesthetictechnique.4.Drugtreatmentmaymodifythenormalcompensatoryphysiologicalresponses,ChoiceofAnesthesia,Factorstochoiceaanesthetictechnique1.Patientcondition2.Surgerycategory3.Thetechnicalandtheoreticlevelofanesthetist4.Anesthetics5.Anesthesiaandmonitorequipment,EquipmentanddrugPreparation,Anestheticmachine1.Electricalsupply2.Allessentialequipmentispresentandcorrectlyassembled3.Medicalgassupply4.Vaporizers5.Breathingsystem:

Ventilators,EquipmentanddrugPreparation,AncillaryEquipment1.laryngoscopes,intubationaids2.Facemasks,airways,trachealtubesandconnectors3.Suctionapparatus,EquipmentanddrugPreparation,Monitoringequipmentanddrug1.NIBP,SpO2,ECG,etc.2.Ephedrine,Atropine,etc3.Anesthetics,PreoperativeMedication,Goalsforpharmacologicpremedication1.Sedationandhypnosis2.Analgesia3.Reducesecretions4.Attenuateautonomicnervoussystemresponses,ThankYou!

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