全身麻醉的实施与并发症Administrationofgeneral.pptVIP

全身麻醉的实施及并发症　 Administration of general anesthesia prophylaxis and treatment of complications 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Section one Administration of general anesthesia General anesthesia is a state of reversible loss of consciousness for the purpose of carrying out surgery. This is achieved by: Analgesia Amnesia Immobility Loss of consciousness Skeletal muscle relaxation 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麻醉药进入体内，利用麻醉药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。 A controllable and reversible loss of consciousness induced by intoxication of the central nervous system. Lowered sensitivity to external stimuli (hyporeflexia), analgesia, unconsciousness, muscle relaxation, and amnesia are significant features of general anesthesia. 全身麻醉方法分类 吸入麻醉 Inhalational Anesthesia 静脉麻醉 Intravenous Anesthesia 诱导前的准备 preparation Preoperative evaluations Intravascular volume Intravenous (IV) access Preoperative medications Monitoring Resuscitation equipment drugs 诱导方法 Induction techniques IV induction Inhalational induction Intramuscular injection of ketamine or oral midazolam：used in uncooperative patients or young children 二、全身麻醉的维持 Maintenance of anesthesia Definition Maintenance begins when the patient is sufficiently anesthetized to provide analgesia,unconsciousness, and muscle relaxation for surgery. Vigilance on the part of the anesthetist is required to maintain homeostasis (vital signs, acid-base balance, temperature, coagulation, and volume status) and regulate anesthetic depth. 麻醉维持方法 Maintenance of anesthesia volatile agents with minimal opioid In a nitrous oxide–opioid relaxant technique IV anesthesia： uses the continuous infusion or repeated boluses of a short-acting hypnotic drug (e.g., propofol) with or without opioids (e.g., remifentanil) and a muscle relaxant. Combinations of the above methods are often used General anesthesia can be combined with