超声引导下对门诊病人的区域麻醉双语.pptxVIP

Ultrasound-guided for Regional Anesthesia for Ambulatory patient(超声引导下对门诊病人的区域麻醉); introduction; introduction; introduction; introduction; introduction; introduction;Local Anesthetics and Adjuvants局部麻醉剂和佐剂;;; ; ; ;; ;Tando and colleagues found no difference in the duration of analgesia between adding 4 mg and 8 mg doses of dexamethasone to interscalene blocks using 40mL bupivacaine. There exact mechanism of this prolongation of action is yet to be elucidated. Tando和同事们发现在40毫升布比卡因加入4或8毫克剂量的地塞米松，行肌间沟阻滞，在镇痛的持续时间上没有不同。延长作用时间的确切机制仍有待阐明。 ;The 5 US-Guided PNBs Every Ambulatory Practitioner Needs and When to Use Them 5种每个医师需要知道及何时使用超声引导下神经阻滞;Mastery of the interscalene (ISB), supraclavicular, femoral股骨, popliteal腘肌 and transverses腹横肌 abdominis plane (TAP) blocks will be adequate for almost all of the needs of the anesthesiologist who has an ambulatory-based practice. 掌握肌间沟、锁骨上,股骨、腘肌和腹横肌平面的阻滞可满足门诊麻醉实践的麻醉医师几乎所有的需要。;Upper Extremity US-Guided Peripheral Nerve Blocks 超声引导下上肢周围神经阻滞 ;;The brachial plexus at the level of the divisions appears as a “bag of grapes” located lateral to the artery. 臂丛的一级分支像“葡萄”样出现位于动脉的一侧。 To perform a supraclavicular block at that level, a 22 gauge block needle is inserted in-plane (parallel to the probe), until it reaches the location that is bordered by the subclavian artery medially, the first rib inferiorly, and the divisions of the brachial plexus superior laterally--the “eight ball in the corner pocket” position. This block is ideal for all procedures of the elbow and distally. 在这样的平面上操作锁骨上神经阻滞,一个22号规格针插入平面(平行于探针),直到它到达锁骨下动脉内侧的位置，在第一肋下缘,上级部门臂丛神经外侧——“八球在角落里的口袋”位置。这阻滞对肘部及远端手术是理想的。 30- 40 ml of local anesthetic will be more than adequate to provide a block. 30 - 40毫升局部麻醉剂足够用来提供阻滞。 ;3) It is then possible to choose the largest of the nerves, appearing as a radiolucent circle and trace it cephalad, as the probe is kept in the horizontal position.然后你就可以选择最