全麻概念专题知识讲座.pptVIP

全麻概念专题知识讲座

Generalanesthesiaisanalteredphysiologicstatecharacterizedbyreversiblelossofconsciousness,analgesiaoftheentirebody,amnesiaandsomedegreeofmusclerelaxation.Induction→Maintenance→Recovery

DefinitionofGeneralAnesthesia

1.InductionofGeneralAnesthesia

Definition全麻诱导是指病人从清醒转为能够进行手术操作旳麻醉状态旳过程。Therearesomecomplicationsorrisksinthisstage,e.g.reductionofbloodpressure,arrhythmia,myocardialischemia.

InductionofGeneralAnesthesia--Methods

①Rapid-sequenceIntravenousInduction

Agentinductiondose(mg/Kg)Diazepam0.2Midazolam0.1-0.2Thiopental3-5Etomidate0.3ketamine1-2Propofol1.5-2.5Fentanyl5-6μg/kgIntravenousinductionagents

MuscleRelaxantsdepolarizingnondepolarizingdose(mg/kg)Succinycholine?1-2?vecuronium0.08-0.1?atracurium0.3-0.6?pancuronium0.08-0.1?Rocuronium0.6-1?

InductionofGeneralAnesthesia

①Rapid-sequenceIntravenousInduction

--DisadvantageandComplications●RegurgitationandVomitting●Cardiovasculardepression●Respiratorydepression●Histaminerelease●Painoninjection●Hiccupandmusclemovements

InductionofGeneralAnesthesia

②InhalationalInduction--Indications

●youngchildren●myastheniagravies●upperairwayobstruction,e.g.Epiglottitis●lowerairwayobstructionwithforeignbody●bronchopleuralfistulaorempyema●noaccessibleveins

InductionofGeneralAnesthesia

InhalationalInduction--Methods

Initially,nitrousoxide70%inoxygenisusedandanesthesiaisdeepenedbygradualintroductionofincrementsofavolatileagent,e.g.Halothane1-3%,Enflurane1.5-2.5%,Isoflurane1-2%.

InductionofGeneralAnesthesia

InhalationalInduction--characteristics●Spontaneousventilationistobe