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1、IntroductionofClinicalAnesthesiaDepartmentofAnesthesiologyLiWenzhiConceptUsingDrugsorothermethodsCentralNerveSystemorperipheralnervesystemLosingsense,painlessandcomfortable,temporarilyWhatcanyoudoforyourfuture?expertiseinresuscitationfluidreplacementai
2、rwaymanagementoxygentransportoperativestressreductionpostoperativepaincontrolICUArchaicanesthesiaStoneAge:spiculaanalgesiaAcupunctureTraditionalmedicinePressureCryotherapyAndothersHistoryofanesthesiology1846publicdemonstrationofetheranesthesiabyWilliam
3、T.G.MortonMorton'setherinhaler(1846)JohnSnow,thefirstanesthesiologist(1846)MachineofInhalationalanesthesiain1847Facemask(1847)HistoryofinhalationAnesthesiamachine(1930)Intravenousanesthetics1934:thiopental1959:diazepam1960:hydroxybutyrate,r-OH1970:ket
4、amine1972:etomidate1976:midazolam1983:propofolOthersOpioidsMorphine,fentanyl,sufentanil,alfentanil,remifentanilRelaxantsCurare,succinylcholine,pancuronium,vecuronium,atracurium,rocuronium,mivacurium,atal.Localanesthetics1884:Cocaineasophthalmicanesthes
5、ia,nerveblock1885:Epiduralanesthesia1898:Spinalanesthesia1901:Caudalanesthesia1905:Procaine1930:Dibucaine1932:Dicaine1943:Lidocaine1996:RopivacaineDevelopingofClinicalAnesthesiology80年代90年代21世纪BPPulseABPCVPS-GcatheterECGTemp.ABP、CVPPETCO2Anesthesia-gas
6、esECGNo-invasiveBP,SPO2TEEBISTOFCCOWorkstationHowaboutourdepartmentofanesthesiology?~1956:surgeon1957:anesthesiagroup60-70:epidural,spinal,nerveblock70-80:CPB,intravenousanesthesia,andinhalationalanesthesia80-85:intravenousanesthesia,inhalationalanesth
7、esia,ECG,arterialbloodpressure,CVP,S-G80-90:inhalationalanesthesiawithtiminginjectionofvolatileanesthetics90-prsent:depthofanesthesia,balanceanesthesiaPETCO2work-station,BIS,TOF,PiCCO21centuryKeydept.&keylab.ofprovince,painclinicalwardPopularanesthesia
8、wordsASAphysicalstatusclassificationsystemTOF:trainoffourBIS:bispectralindexSG:SwanGanzcatheterMAC:minimumalveolarconcentrationTEE:transesophagealechocardiographyTheworkingfieldofAnesthesiologistsClinicanesthesiaOperatingroom,PACU,outpa