Clinical Anaesthesiology临床麻醉学.pptVIP

Clinical Anaesthesiology Qiu Wei Fan Associate professorDepartment of AnaesthesiologyRui Jin HospitalShanghai Second Medical University Local Anaesthetic techniques Features of local anaesthesia Methods of local anaesthesia Complications of local anaesthesia Regional block equipment Spinal, epidural, caudal blocks Peripheral nerve blocks Preoperative assessment and premedication Purpose Establish rapport with the patient Obtain a history and perform a physical examinations Order a special investigations Assess the risks of anaesthesia and surgery and if necessary postpone or cancel the date of surgery Instutite preoperative management Prescribe premedication and the anaesthesia management Preoperative assessment and premedication Routine preoperative anaesthetic evaluation History Current problem Other known problems Medication history Preoperative assessment and premedication Medication history Allergies Drug intolerances Present therapy Prescription Nonprescription Nontherapeutic Alcohol Tobacco Illicit Preoperative assessment and premedication Previous anaesthetics, surgery, and obstetric deliverries Family history Review of organ systems Last oral intake  Preoperative assessment and premedication Review of organ systems General Respiratory Cardiovascular Renal Gastrointestinal Hematologic Preoperative assessment and premedication Review of organ systems Neurologic Endocrine Psychiatric Orthopedic Dermatologic Preoperative assessment and premedication Physical examination Vital signs Airway Heart Lungs Extremities Neurologic examination Preoperative assessment and premedicationLaboratory evaluation Hematocrit or hemoglobin concentrationAll menstruating womenAll patients over 60 years of ageAll patients who are likely to experience significant blood loss and may require transfusion Serum glucose and creatinine (or blood urea nitrogen) concentration: all patients over 60 years of age E