全身麻醉的实施并发症Administrationofgeneral.ppt

全身麻醉的实施及并发症Administrationofgeneralanesthesia&plications长江大学临床医学院外科教研室目的要求掌握全麻的基本概念及基本要求。熟悉全麻的诱导、维持和苏醒期的特点及管理期注意事项。了解全麻深浅的判断、临床常用的判断麻醉深浅的监测指标。第一节全身麻醉的实施:AnalgesiaAmnesiaImmobilityLossofconsciousnessSkeletalmusclerelaxation全身麻醉的基本特征通过呼吸道吸入、静脉注射、肌肉注射或直肠灌注等方式使***进入体内,利用***对中枢神经系统产生的抑制作用,可逆地改变中枢神经系统中的某些功能,从而达到神志消失、(手术时)无痛的目的。 (hyporeflexia),analgesia,unconsciousness,musclerelaxation, InhalationalAnesthesia 静脉麻醉 IntravenousAnesthesia一、麻醉诱导preparationPreoperativeevaluationsIntravascularvolumeIntravenous(IV)accessPreoperativemedicationsMonitoringResuscitationequipment&drugs诱导方法InductiontechniquesIVinductionInhalationalinductionIntramuscularinjectionofketamineororalmidazolam:usedinuncooperativepatientsoryoungchildren二、全身麻醉的维持MaintenanceofanesthesiaDefinitionMaintenancebeginswhenthepatientissufficientlyanesthetizedtoprovideanalgesia,unconsciousness,(vitalsigns,acid-basebalance,temperature,coagulation,andvolumestatus)MaintenanceofanesthesiavolatileagentswithminimalopioidInanitrousoxide–opioidrelaxanttechniqueIVanesthesia:usesthecontinuousinfusionorrepeatedbolusesofashort-actinghypnoticdrug(.,propofol)withorwithoutopioids(.,remifentanil)binedwitharegionalanesthetictechnique