generalanaesthesia全身麻醉

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1、ClinicalAnaesthesiologyQiuWeiFanAssociateProfessorDepartmentofAnaesthesiologyRuiJinHospitalShanghaiSecondMedicalUniversityGeneralAnaesthesiaClassificationofGeneralAnaesthesiaMethodsInhalationanaesthesiaIntravenousanaesthesiaIntramuscularlyRectallyOrallyBalancedan

2、aesthesiaClinicalPharmacologyInhalationalanaestheticagentsAgentMAC%VaporPressureBlood/GasPartitionNitrousoxide105-0.47Halothane0.742432.4Enflurane1.681751.9Isoflurane1.152401.4Desflurane6.06810.42ClinicalPharmacologyIntravenousanaestheticagentsAgentInductiondose(mg·k

3、g-1)Thiopentone3-5Methohexitone1-1.5Etomidate0.3Propofol1.5-2.5Ketamine2ClinicalPharmacologyDrugsusedtosupplementanaesthesiaAnalgesicsOpioidagonistsNaturalopiumalkaloids:Morphine,CodeineSemisyntheticopiumalkaloid:DiamorphineSyntheticopioids:Pethidine,Fentanyl,Alfenta

4、nil,Sufentanil,RemifentanilPartialopioidagonistsBuprenorphineClinicalPharmacologyDrugsusedtosupplementanaesthesiaOpioidagonist/antagonistsPentazocineOpioidantagonistsNaloxoneClinicalPharmacologyMuscleRelaxantsNeuromuscularblockingagentsaredividedintotwoclasses:Depola

5、rizingNondepolarizingClinicalPharmacologyMuscleRelaxantsDepolarizingShort-actingSuccinylcholineDecamethoniumNondepolarizingLong-actingTubocurarineMetocurinedoxacuriumPancuroniumPipecuriumIntermediate-actingAtracuriumVecuroniumShort-actingMivacuriumClinicalPharmacolog

6、yDrugsaffectingtheautonomicnervoussystemSympathomimeticdrugsAdrenaline(low-α,β1+2)(higher-α)Isoprenaline(β1+2)Noradrenaline(α,β1)Phenylephine(α)Dopamine(low-δ,moderate-δ,β1+2,moderatehigh-α,β1)Dobutamine(β1)ThepracticalconductofanaesthesiaPreparationforanaesthesiaEqu

7、ipmentformonitoringTheanaestheticmachineEquipmentrequiredfortrachealintubationAnaestheticapparatusTheanaesthesiamachineGasinlets&pressureregulatorsOxygenpressurefailuredevices&oxygenflushvalvesFlowcontrolvalvesFlowmeters&spirometersVaporizersVantilators&disconnectala

8、rmsWastegasscavengersHumidifiers&nebulizersOxygenanalyzersAirwaymanagementequipmentOral&NasalairwayMaskEndotrachealtubeRigidlaryngo