临床麻醉学(英)

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1、ClinicalAnesthesiaCARLL.GWINNUTTContentsForewordPrefaceAcknowledgements1.AnestheticAssessmentandPremedication2.TheDeliveryofAnestheticGasesandVapors3.ManagingtheAirway4.DrugsassociatedwithAnesthesia5.MeasurementandMonitoring6.IntravenousCannulationand

2、FluidAdministration7.PostanesthesiaCare8.LocalandRegionalAnesthesia9.AnIntroductiontoIntensiveCare10.AnesthetistsandChronicPainRelief11.ResuscitationoftheCollapsedPatient12.IndexCHAPTER1AnestheticAssessmentandPremedicationThepreoperativevisit,Speciali

3、nvestigations,Informingthepatient,Anesthetichistoryandexamination,Medicalreferral,Premedication,Riskassessment,Furtherreading.ThepreoperativevisitThemainaimistoassessthepatient’sfitnessforanesthesiaandthereisnodoubtthatthisisbestperformedbyandanesthet

4、ist,preferablytheonewhoisgoingtoadministertheanesthetic.Thevisitallowsthemostsuitableanesthetictechniquetobedetermined,anypotentialinteractionsbetweenconcurrentdiseasesandanesthesiaanticipated,andfinallyprovidesanexplanationandreassuranceforthepatient

5、.Wherethereiscoexistingillness,everyopportunitymustbetakentoimprovethepatient’sconditionpriortosurgery.Thismaymeanseekingadvicefromotherspecialiststooptimizetreatments,althoughthefinaldecisionwillrestwiththeanesthetist.Inanidealworld,allpatientswouldb

6、eseenbytheiranesthetistsufficientlyaheadoftheplannedsurgerytoallowanyproblemsidentifiedtobetreatedwithoutinterferingwiththesmoothrunningoftheoperatinglist.Forelectivesurgery,patientsarerarelyadmittedmorethan24hoursinadvanceandmaynotbeseenbytheanesthet

7、istuntiltheeveningpriortosurgery.Theanesthetistfrequentlyreliesuponthejuniorsurgicalstafftoensurethatallpatientshaveafullhistoryandexaminationsothatduringtheirvisittheycanconcentrateontheareasofrelevancetoanesthesiaasdetailedbelow.Therearethreesituati

8、onswherespecialarrangementsareusuallymade.1Patientswithcomplexmedicalorsurgicalproblems.Thepatientisoftenadmittedseveraldaysbeforesurgeryandtheanesthetistisactivelyinvolvedinoptimizingtheirconditionpriortoanesthesiaandsurgery.2Surgicalemergenc