,*,常见心律失常心电图诊断的误区诺如病毒感染的防控知识介绍责任那些事浅谈用人单位承担的社会保险法律责任和案例分析现代农业示范工程设施红地球葡萄栽培培训材料,2010-6-10,*,常见心律失常心电图诊断的误区诺如病毒感染的防控知识介绍责任那些事浅谈用人单位承担的社会保险法律责任和案例分析现代农业示范工程设施红地球葡萄栽培培训材料,ANESTHESIOLOGY,Pei Xuxing,Department of Anesthesiology,Peoples Hospital of Henan Province,.,ANESTHESIOLOGYPei Xuxing Depa,1,Contents,The history of anesthesiology,The scope of anesthesiology,Classification of Anesthesia,Definition of Anesthesia,Preparing for anesthesia,.,ContentsThe history of anesthe,2,The History of Anesthesiology,Anesthetic practices date from ancient times,.,The History of AnesthesiologyA,3,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 AnesthesiologyM,4,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 AnesthesiologyM,5,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 History of AnesthesiologyT,6,The Scope of Anesthesiology,1.Clinical anesthesia,2.Pain management,3.First-aid and resuscitation,4.Intensive care,.,The Scope of Anesthesiology1.C,7,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,.,8,术前给药麻醉诱导麻醉维持呼吸管理循环管理苏醒麻醉恢复静脉诱导,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.,.,Definition of Anesthesia Anest,9,Course of Anesthesia,Anesthesia induction,Anesthesia maintenance,Anesthesia recovery,.,Course of AnesthesiaAnesthesia,10,Classification of Anesthesia,General anesthesia,Inhalation anesthesia,Intravenous anesthesia,Combined anesthesia,Intravenous,Venous-inhalation,Intrathecal block-general anesthesia,Local anesthesia,Topical anesthesia,Infiltration anesthesia,Nerve block,Nerve plexus block,Intrathecal block:Subarachnoid block,epidural block and caudal block,.,Classification of AnesthesiaGe,11,Monitoring During Anesthesia,The Cardiovascular System,The Respiratory System,Liver and kidney function,Central nerve system,Coagulation function,.,Monitoring During AnesthesiaTh,12,Pain Management,Postoperative analgesia,Delivery analgesia,Acute and chronic pain cure,Cancer analgesia,.,Pain ManagementPostoperative a,13,Preparing For Anesthesia,Preoperative visit,Preoperative evaluation:,History,physical examination,laboratory evaluation,Preoperative fasting,Coexisting disease therapy,Equipment preparation,Preoperative medication,.,Preparing For AnesthesiaPreope,14,Purposes of the preoperative visit,Establish rapport with the patient,Obtain a history and perform a physical examinations,Order a special investigations,Assess the risks of anesthesia and surgery,Institute preoperative management,.,Purposes of the preoperative v,15,Routine Preoperative Anesthetic Evaluation,History,Review of organ system,clinical examination,Laboratory Evaluation,.,Routine Preoperative Anestheti,16,ASA Physical Status Classification,Class,Definition,1,A normal healthy patient.,2,A patient with mild systemic disease and no functional limitation,3,A patient with moderate to severe systemic disease that results in some functional limitation,4,A patient with severe systemic disease that is a constant threat to life and functionally incapacitating,5,A moribund patient who is not expected to survive 24 hours with or without surgery,E,If the procedure is an emergency,the physical status is followed by,“,E,”,.,ASA Physical Status Classifica,17,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.,.,Preoperative FastingThe time o,18,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 TherapyCoe,19,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,.,Coexisting Disease Therapy1.Th,20,Choice of Anesthesia,Factors to choice a anesthetic technique,1.Patient condition,2.Surgery category,3.The technical an