麻醉概述英文

ANESTHESIOLOGY,Pei Xuxing Department of Anesthesiology Peoples Hospital of Henan Province,Contents,The history of anesthesiology The scope of anesthesiologyClassification of AnesthesiaDefinition of AnesthesiaPreparing for anesthesia,The History of Anesthesiology,Anesthetic practices date from ancient times,The History of Anesthesiology,Modern anesthesiology began in 1846 - Ether was used as an anesthetic agent in humans.,William T. G. Morton (1819-1868),The History of Anesthesiology,Modern 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 in evolution of anesthesiology-Curare(箭毒)was firstly used in 1942,The History of Anesthesiology,The original of modern local anesthesia was credited to use of cocaine in 1884.Subarachnoid anesthesia - 1898. Caudal epidural anesthesia- 1901. lumbar epidural anesthesia - 1921,The Scope of Anesthesiology,1.Clinical anesthesia2.Pain management3.First-aid and resuscitation4.Intensive care,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,Definition of Anesthesia,Anesthesia is always defined by drug-induced changes in behavior or perception. The components of general anesthetic state include unconsciousness, amnesia(健忘), analgesia(镇痛), immobility, and attenuation of autonomic nervous system responses to noxious stimulation.,Course of Anesthesia,Anesthesia inductionAnesthesia maintenanceAnesthesia recovery,Classification of Anesthesia,General anesthesiaInhalation anesthesiaIntravenous anesthesiaCombined anesthesiaIntravenous Venous-inhalationIntrathecal block- general anesthesia,Local anesthesiaTopical anesthesiaInfiltration anesthesiaNerve blockNerve plexus blockIntrathecal block: Subarachnoid block, epidural block and caudal block,Monitoring During Anesthesia,The Cardiovascular SystemThe Respiratory SystemLiver and kidney functionCentral nerve systemCoagulation function,Pain Management,Postoperative analgesiaDelivery analgesiaAcute and chronic pain cureCancer analgesia,Preparing For Anesthesia,Preoperative visitPreoperative evaluation: History, physical examination, laboratory evaluationPreoperative fastingCoexisting disease therapyEquipment preparationPreoperative medication,Purposes of the preoperative visit,Establish rapport with the patient Obtain a history and perform a physical examinationsOrder a special investigationsAssess the risks of anesthesia and surgery Institute preoperative management,Routine Preoperative Anesthetic Evaluation,HistoryReview of organ systemclinical examinationLaboratory Evaluation,ASA Physical Status Classification,Preoperative Fasting,The 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, baby should be transfused.,Coexisting Disease Therapy,Coexisting 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 interact with anesthesia and surgery in several ways,Coexisting Disease Therapy,1.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 technique.4.Drug treatment may modify the normal compensatory physiological responses,Choice of Anesthesia,Factors to choice a anesthetic technique 1.Patient condition 2.Surgery category 3.The technical and theoretic level of anesthetist 4.Anesthetics 5.Anesthesia and monitor equipment,Equipment and drug Preparation,Anesthetic machine1.Electrical supply2.All essential equipment is present and correctly assembled3.Medical gas supply4.Vaporizers5.Breathing system: Ventilators,Equipment and drug Preparation,Ancillary Equipment 1.laryngoscopes, intubation aids 2.Face masks, airways, tracheal tubes and connectors 3.Suction apparatus,Equipment and drug Preparation,Monitoring equipment and drug 1.NIBP, SpO2, ECG, etc. 2.Ephedrine