《非住院病人的麻醉》ppt课件

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1、非住院病人的麻醉OutpatientAnesthesiaBenefitsofAmbulatorySurgeryPatientpreference,especiallychildrenandelderlyLackofdependenceonavailabilityofhospitalbedsGreaterflexibilityinschedulingoperationsLowmorbidityandmortalityLowerincidenceofinfectionLowerincidenceofrespiratorycomplicationsHighervolumeofpati

2、ents(greaterefficiency)ShortersurgicalwaitinglistsLoweroverallproceduralcostsLesspreoperativetestingandpostoperativemedicationBenefitsofAmbulatorySurgeryPatientSelectionDurationofsurgeryLessthan90minutesPatientcharacteristicsMalignanthyperthermiasusceptibilityObserveforatleast4hourspostopera

3、tivelyExtremesofageAgealoneshouldnotbeconsideredadeterrentintheselectionContraindicationstoOutpatientSurgerySerious,potentiallylife-threateningdiseasesthatarenotoptimallymanaged(ASAⅢ～Ⅳ):brittlediabetes,unstableangina,symptomaticasthmaMorbidobesitycomplicatedbyhemodynamicorrespiratoryproblems

4、Drugtherapy:monoamineoxidaseinhibitors;acutesubstanceabuseContraindicationstoOutpatientSurgeryEx-prematureinfantslessthan60weekspostconceptualageLackofaresponsibleadultathometocareforthepatientontheeveningaftersurgeryPreoperativePreparationAimedatreducingtherisksinherentinambulatorysurgery,i

5、mprovingpatientoutcome,andmakingthesurgicalexperiencepleasantforthepatientandfamilyPreoperativePreparationPrepatationshouldminimizepatientanxietythroughpharmacologicandnon-pharmacologicmeansandshouldreducepotentialpostoperativeproblemsbyuseofappropriatepremedicationNonpharmacologicPreparatio

6、nPharmacologicprepatationAnixolysisandsedationAnalgesicsPreventionofnauseaandvomitingPreventionofaspirationpneumonitisNothing-by-mouthGuidelinesAnetheticTechniquesQuality,safety,efficiency,andthecostofdrugsandequipmentareimportantconsiderationsinchoosingananesthetictechniqueforoutpatientsurg

7、eryAnetheticTechniquesTheabilitytodeliverasafeandcost-effectivegeneralanestheticwithminimalsideeffectsandrapidrecoveryiscriticalinabusyoutpatientsurgeryunitGeneralanesthesiaremainsthemostwidelyusedanesthetictechniqueformanagingambulatorysurgerySpec