临床麻醉学绪论ppt整理.ppt

Introduction of Clinical Anesthesia Department of Anesthesiology Li Wenzhi Concept Using Drugs or other methods Central Nerve System or peripheral nerve system Losing sense, painless and comfortable, temporarily What can you do for your future? expertise in resuscitation fluid replacement airway management oxygen transport operative stress reduction postoperative pain control ICU Archaic anesthesia Stone Age: spicula analgesia Acupuncture Traditional medicine Pressure Cryotherapy And others History of anesthesiology 1846 public demonstration of ether anesthesia by William T. G. Morton Mortons ether inhaler (1846) John Snow, the first anesthesiologist（1846） Machine of Inhalational anesthesia in 1847 Face mask(1847) History of inhalation Anesthesia machine (1930) Intravenous anesthetics 1934: thiopental 1959: diazepam 1960: hydroxybutyrate, r-OH 1970: ketamine 1972: etomidate 1976: midazolam 1983: propofol Others Opioids Morphine, fentanyl, sufentanil, alfentanil, remifentanil Relaxants Curare, succinylcholine, pancuronium, vecuronium, atracurium, rocuronium, mivacurium, at al. Local anesthetics 1884：Cocaine as ophthalmic anesthesia, nerve block 1885：Epidural anesthesia 1898: Spinal anesthesia 1901：Caudal anesthesia 1905：Procaine 1930：Dibucaine 1932：Dicaine 1943：Lidocaine 1996: Ropivacaine Developing of Clinical Anesthesiology How about our department of anesthesiology? ～1956：surgeon 1957：anesthesia group 60-70：epidural, spinal, nerve block 70-80：CPB, intravenous anesthesia, and inhalational anesthesia 80-85: intravenous anesthesia, inhalational anesthesia, ECG, arterial blood pressure, CVP, S-G 80-90：inhalational anesthesia with timing injection of volatile anesthetics 90-prsent：depth of anesthesia, balance anesthesia PETCO2 work-station, BIS, TOF, PiCCO 21 century Key dept. key lab. of province, pain clinical ward Popular anesthesia words ASA physical status classifica