,*,2010-6-10,*,ANESTHESIOLOGY,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,Contents,The history of anesthesiology,The scope of anesthesiology,Classification of Anesthesia,Definition of Anesthesia,Preparing for anesthesia,仕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 Anesthesiology,Anesthetic 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 Anesthesiology,Modern anesthesiology began in 1846-,Ether,was used as an anesthetic agent in humans.,William T.G.Morton,(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 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,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 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,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 Anesthesiology,1.Clinical anesthesia,2.Pain management,3.First-aid and resuscitation,4.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,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,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,amnesia(,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 Anesthesia,Anesthesia induction,Anesthesia maintenance,Anesthesia 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,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,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 Anesthesia,The Cardiovascular System,The Respiratory System,Liver and kidney function,Central nerve system,Coagulation 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 Management,Postoperative analgesia,Delivery analgesia,Acute and chronic pain cure,Cancer 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 Anesthesia,Preoperative visit,Preoperative evaluation:,History,physical examination,laboratory evaluation,Preoperative fasting,Coexisting disease therapy,Equipment preparation,Preoperative medication,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 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,米脚宽羌窿刊版核节祈章杆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 Evaluation,History,Review of organ system,clinical examination,Laboratory 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 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,”,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 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.,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 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,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 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,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 Anesthesia,Factors