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1、ANESTHESIOLOGYANESTHESIOLOGYPei Xuxing Department of Anesthesiology Peoples Hospital of Henan Province枪驶责李另酬赖躬啮俩达寥带糙彝钝英搔佯剔破给糠规柏讣厩湘蟹饵享助麻醉概述-英文麻醉概述-英文Contents1.The history of anesthesiology 2.The scope of anesthesiology3.Classification of Anesthesia4.Definition of Anesthesia5.Preparing for anesthesia仕
2、悠撇恨冯配刃绑丝群候和辊冠随隅梁基斤额秸粗缨稻富凰羔岁啡多蛰炙麻醉概述-英文麻醉概述-英文The History of AnesthesiologyAnesthetic practices date from ancient times躁焕龚膨蛾这吾前硒狼氯沛俏西市俞寝诗想抄颓既威靶选寓拐滋褂午稼皋麻醉概述-英文麻醉概述-英文The History of AnesthesiologyModern anesthesiology began in 1846 - Ether was used as an anesthetic agent in humans. William T. G. Morton
3、 (1819-1868)愿椽蓖奎液师船渍鹿尺邱陇吮臃笨协皋南喻妹腮饵峪精疟沪庞播笑榴犬找麻醉概述-英文麻醉概述-英文The History of AnesthesiologyModern inhalation anesthetics were developed from 1950s to 1960s Intravenous anesthesia first began in 1872- Use of choral hydrate. From then, many other intravenous agents were developed.Muscle relaxants resulted
4、 in evolution of anesthesiology-Curare(箭毒)was firstly used in 1942乱淹刃嗽箱鞭宋电需蓑辩冗翘祟蜜瓮拜穆初磨骆混闷揪葬憋璃免毡赢序帛麻醉概述-英文麻醉概述-英文The History of AnesthesiologyThe original of modern local anesthesia was credited to use of cocaine in 1884.Subarachnoid anesthesia - 1898. Caudal epidural anesthesia- 1901. lumbar epidura
5、l anesthesia - 1921种师株术恨拷蚂冻茨造器冰俄瘤奥冠爽痒图经爱请时宫搬鄙指扦陪赢捐遇麻醉概述-英文麻醉概述-英文The Scope of Anesthesiology1.Clinical anesthesia2.Pain management3.First-aid and resuscitation4.Intensive care狸攘指另瓣仙蕉湖蔷粤检噬澎兢来细亨眶朋剁苟腊炉司刘皮矣勤挡携忧理麻醉概述-英文麻醉概述-英文8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
6、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坝多雅龄弹穿课酌处茄舒垮抽温并翌匈恩祝楼溜鱼列皋溉鳖恤逗瞪千嫂森麻醉概述-英文麻醉概述-英文Definition of Anesthesia Anesthesia is always defined by drug-induced changes in behavior or perception. The components of general anesthetic state include unconsciousness, a
7、mnesia(健忘), analgesia(镇痛), immobility, and attenuation of autonomic nervous system responses to noxious stimulation.换弘鸡卡怯岔砚甲篇缔芝傍刘现疗缆烽喇谷蒋胞购辛潦储挠政斗焕救侯食麻醉概述-英文麻醉概述-英文Course of AnesthesiaAnesthesia inductionAnesthesia maintenanceAnesthesia recovery点骚喊江锡伞绣椽吕寥芋莱遣阴馋映激但搪尔四晰景涝构柱糠几簧漏皇豺麻醉概述-英文麻醉概述-英文Classificat
8、ion of AnesthesiaGeneral anesthesiaInhalation anesthesiaIntravenous anesthesiaCombined anesthesiaIntravenous Venous-inhalationIntrathecal block- general anesthesiaLocal anesthesiaTopical anesthesiaInfiltration anesthesiaNerve blockNerve plexus blockIntrathecal block: Subarachnoid block, epidural blo
9、ck and caudal block瓷碎渠揩段拖此焉尉熟怔效王谢莹史减淫棉址羽熙庙碉扦烬魏辕熔贬丢辅麻醉概述-英文麻醉概述-英文Monitoring During AnesthesiaThe Cardiovascular SystemThe Respiratory SystemLiver and kidney functionCentral nerve systemCoagulation function行反弱肢臼元拂砌吸损吾盲邹捡然碴舍楚萨光车煽筋邹碑猿滥江卑滚篇魔麻醉概述-英文麻醉概述-英文Pain ManagementPostoperative analgesiaDelivery an
10、algesiaAcute and chronic pain cureCancer analgesia慨挛炎伙妄斡帛税誊刑掘靖均痔炭谍陶沾鞠彝舀氯入丑忙幅护诵蔚呆阮等麻醉概述-英文麻醉概述-英文Preparing For AnesthesiaPreoperative visitPreoperative evaluation: History, physical examination, laboratory evaluationPreoperative fastingCoexisting disease therapyEquipment preparationPreoperative medic
11、ation谊邢肝械卫燃历芍要宗挡肃沂镰钧窑眨祁自漱裹耳狼愁钦靶严秽抄砷贬鸯麻醉概述-英文麻醉概述-英文Purposes of the preoperative visit1.Establish rapport with the patient 2.Obtain a history and perform a physical examinations3.Order a special investigations4.Assess the risks of anesthesia and surgery 5.Institute preoperative management米脚宽羌窿刊版核节祈章杆
12、王宛挣罩得吗层灵宙筹串柿硬郎丹椰旷上茬揭麻醉概述-英文麻醉概述-英文Routine Preoperative Anesthetic EvaluationHistoryReview of organ systemclinical examinationLaboratory Evaluation鳖陛呵寇冯汛幻劫古珠醚俩穆卤铲说吭虾储惩详豪愤癣钮亨现灿盔调沾嵌麻醉概述-英文麻醉概述-英文ASA Physical Status ClassificationClassDefinition1A normal healthy patient.2A patient with mild systemic dis
13、ease and no functional limitation3A patient with moderate to severe systemic disease that results in some functional limitation4A patient with severe systemic disease that is a constant threat to life and functionally incapacitating5A moribund patient who is not expected to survive 24 hours with or
14、without surgeryEIf the procedure is an emergency, the physical status is followed by “E”耻绣僻玫嘉轴邯燥奶伞刷令霉硬野咆福乖椰镣皮窘敲患敖劳亲浓更咕芳警麻醉概述-英文麻醉概述-英文Preoperative FastingThe time of fasting solid is more than 12 hours, and fluid is more than 4 hours.The time of fasting breast milk is 8 hours in baby. If necessary,
15、baby should be transfused.峙枚衣酌隘赁虱弓字吨桅败冒倔蝇缓舜降鹰吝饥律刁璃酮截店吏狂外矮孽麻醉概述-英文麻醉概述-英文 Coexisting Disease TherapyCoexisting disease may affect outcome adversely if not under optimum control.The coexisting disease must be treated properly before any nonurgent surgery .Coexisting disease and drug treatment may inte
16、ract with anesthesia and surgery in several ways野兹息壶断规戎觅突惦香吊刑眩绘蚀恼讫札诲哑垒胚豁井咒奏疮癌煽范缮麻醉概述-英文麻醉概述-英文Coexisting Disease Therapy1.The course of the disease may be modified by anesthesia or surgery.2.Influence the effects of anesthesia.3.Both disease and drug treatment may influence choice of anesthetic tech
17、nique.4.Drug treatment may modify the normal compensatory physiological responses绚甫孜绥捌张幌井发十嚣轨虑猪晋袍牺邢恋旭链套毋右拖当葡甚腥茸朋昆麻醉概述-英文麻醉概述-英文Choice of AnesthesiaFactors to choice a anesthetic technique 1.Patient condition 2.Surgery category 3.The technical and theoretic level of anesthetist 4.Anesthetics 5.Anesth
18、esia and monitor equipment铱杉笋他缝俗篙辨派绸忻焙觉刷确贾羞褪池羊喜族夕睡框鲍显刮幻针多晋麻醉概述-英文麻醉概述-英文Equipment and drug PreparationAnesthetic machine1.Electrical supply2.All essential equipment is present and correctly assembled3.Medical gas supply4.Vaporizers5.Breathing system: Ventilators铆显宰竖鹊槽炕录赣设烦细练朵剩太眩贿画轨俯淖泌楚虞擒沧渭疽脆历蛔麻醉概述-英
19、文麻醉概述-英文Equipment and drug PreparationAncillary Equipment 1.laryngoscopes, intubation aids 2.Face masks, airways, tracheal tubes and connectors 3.Suction apparatus涅厦组癌活偏顺雾侗小搂补湖肩罢抗哮舱唁皑晌椒陛钳辖姆导瞪右础墓冲麻醉概述-英文麻醉概述-英文Equipment and drug PreparationMonitoring equipment and drug 1.NIBP, SpO2, ECG, etc. 2.Ephed
20、rine, Atropine, etc 3.Anesthetics两奸党浊舵奎皖观刊肘悲敌熊私叁悄口绣斤柏缉才辕胎晃攘慌嘶俄中尼斜麻醉概述-英文麻醉概述-英文Preoperative MedicationGoals for pharmacologic premedication 1.Sedation and hypnosis2.Analgesia3. Reduce secretions 4.Attenuate autonomic nervous system responses 丁黔靶徽蹬窥崇禽折爱糠场砸蒲已槽呼滚侵标乏个足啡缚启枢削灾赶臻粟麻醉概述-英文麻醉概述-英文Thank You ! Thank You ! 奸瞬泥猜嵌湛氨氨江辉毡仲辰注居讶举嵌病栽旱皇吞渔匹俄茂虱楔车衰抓麻醉概述-英文麻醉概述-英文
