欢迎来到天天文库
浏览记录
ID:22020377
大小:616.50 KB
页数:14页
时间:2018-10-26
《麻醉后寒战英文版》由会员上传分享,免费在线阅读,更多相关内容在教育资源-天天文库。
1、postanesthesiashiveringHuangYayiPostanesthesiashivering?spontaneous,involuntary,tremor-likemuscle-hyperactivityClinicalConsiderationsHypothermia:<36oCO2consumptionx5;decreasesaturation;myocardialischemiaandanginaIncreasedmortalityrateMonitoringsiteTympanicmembraneNasopharyngealm
2、ucosaRectumEsophagusEpidemiology40-60%aftervolatileanestheticsYoungmaleadult,rareinelderorchildrenLengthofanesthesiaorsurgeryPeri-oprewarmingprocedure:ifnotMildhypothermiaAnestheticusedPathophysiologyConsequenceofpostanestheticshiveringDiscomfortIncreasedpainIICP,IOPO2consumptio
3、n(VO2):more40–120%IncreasedminuteventilationCardiacmorbidityPathophysiologyTwotypesofpostanestheticshiveringThermoregulatedshiveringWithcutaneousvasoconstriction,theresponseofhypothermiaPerioperativehypothermiaNon-thermoregulatedshiveringMechanismunknownPostoperativepainrelated?
4、PathophysiologyOriginsofPostanestheticShiveringPerioperativehypothermiaPostoperativepainPerioperativeheatlossDirecteffectofcertainanestheticsHypercapniaorrespiratoryalkalosisTheexistenceofpyogensHypoxiaPathophysiologyHumandefensestohypothermiaSkinvasomotoractivityNonshiveringthe
5、rmogenesisShiveringSweatingShiveringisthelast-resortdefensePrevention&ManagementPerioperativeHypothermiaPreventionLimitingtheeffectsofinternalredistributionReduceheatlossIntravenousfluidrewarmingPrevention&ManagementPassivepreventionisnotenoughActiveheattransfer1/3coverofthecuta
6、neoussurfaceisenoughUnderGA>vasodilatation>heatlossPrevention&ManagementPhysicaltreatmentShiveringthreshold:RaisetemptoinhibitpostoperativeshiveringRadiationheatsystemForcedairwarmer:Prevention&ManagementMedicaltreatmentOpiates:MeperidineCentralstimulant :Doxapramα2-AdrenergicAg
7、onists:ClonidineInhibitreuptakeof5-HT,NE:Tramadol,Ketanserin,NefopamandOndensetronOtherdrugsConclusionHypothermiaishighriskPreventionofhypothermiaconsistsoflimitingheatlossandactiverewarmingsystemEffectivetreatmentisnecessarySkinsurfacerewarmingislessefficientthenmedicaltreatmen
8、tor,incertainsituationssuggestedthatpainandther
此文档下载收益归作者所有