General Anaesthesia全身麻醉.pptVIP

Clinical Anaesthesiology Qiu Wei Fan Associate ProfessorDepartment of AnaesthesiologyRui Jin Hospital Shanghai Second Medical University Classification of General Anaesthesia Methods Inhalation anaesthesiaIntravenous anaesthesiaIntramuscularlyRectallyOrallyBalanced anaesthesia Clinical PharmacologyInhalational anaesthetic agents Agent MAC% Vapor Pressure Blood/Gas Partition Nitrous oxide 105 - 0.47 Halothane 0.74 243 2.4 Enflurane 1.68 175 1.9 Isoflurane 1.15 240 1.4 Desflurane 6.0 681 0.42 Clinical PharmacologyIntravenous anaesthetic agents Agent Induction dose (mg·kg-1) Thiopentone 3-5 Methohexitone 1-1.5 Etomidate 0.3 Propofol 1.5-2.5 Ketamine 2 Clinical PharmacologyDrugs used to supplement anaesthesia Analgesics Opioid agonists Natural opium alkaloids: Morphine,Codeine Semisynthetic opium alkaloid: Diamorphine Synthetic opioids:Pethidine, Fentanyl, Alfentanil, Sufentanil, Remifentanil Partial opioid agonists Buprenorphine Clinical PharmacologyDrugs used to supplement anaesthesia Opioid agonist/antagonists Pentazocine Opioid antagonists Naloxone Clinical PharmacologyMuscle Relaxants Neuromuscular blocking agents are dividedinto two classes: Depolarizing Nondepolarizing Clinical PharmacologyMuscle Relaxants Depolarizing Short-acting Succinylcholine Decamethonium Nondepolarizing Long-acting Tubocurarine Metocurine doxacurium Pancuronium Pipecurium Intermediate-acting Atracurium Vecuronium Short-acting Mivacuriu