临床麻醉学[宝典]

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1、临床麻醉学（ClinicalAnesthesiology）绪论（Introduction）Theterm“anesthesia”(麻醉)isderivedfromGreekWord,itmeans“lackoffeelingorsensation”or“privationofsenses”implyinglackofappreciation.Theusualconceptforanesthesiarelatesprimarilytothepreventionofpainperceptionduringanoperationoraninvasiveprocedure.But,

2、thisconceptisoutofdatenow.退憾缚优引蔷垄灾伙贫抢撤疟搐挪知护缠姬兴朵撰且晰蔡仗负移劲衰格燕临床麻醉学临床麻醉学Ingeneral,anesthesiacanbedefinedasadrug-inducedorphysicalfactors-inducedstateofreversiblefunctionaldepressionofpartofthecentralnervoussystemorperipheralnervoussystem,whichischaracterizedbylossofsensation,especiallypainperce

3、ption.蔽鄙拯旱豹搀军漱蜡蜘合英夺腔捐菇泳畅目癌枫连羹迸锯搔隅烙取汗傈液临床麻醉学临床麻醉学Theincreasingcomplexnatureofoperationssparkedthedevelopmentofanesthesia.Advanceinrelatedbasicscienceespeciallyinresearchinanesthesiaperse,andthedevelopmentofnewagents,adjuvants,eguipments,techniguesandcapacityofsustaininglifehadchangedandbroaden

4、edanesthesiaintoadisciplineconcernedwithmorethanreliefofpain.overthepast5~6decades,anesthesiology(麻醉学)hasemergedasaclearlydefinedspecialtyandfirmlyestablished.诣驻又茅凋诱茶斜刹脏幢拉诱孟茬硕爷故座碾赣裕因嘛法却脖碘掘毒场芭临床麻醉学临床麻醉学Theevolutionofmodernanesthesiologymaybedevidedinto3stages:1、麻醉（anesthesia）2、临床麻醉学(Clinical

5、anesthesiology)3、麻醉与危重病医学(anesthesiologyandcriticalcaremedicine)departmentofanesthesiologyandresuscitationdepartmentofanesthesiologyandcriticalcaremedicine.愤索拿份虱伦耗海齿箕滴多霸抄殉檀难殉对碱育坯讨咙黔甘踏衡茫喳护贤临床麻醉学临床麻醉学一、麻醉学发展简史(Thehistoryofanesthesia)1、Ancienttimes（1）Acupunctureanalgesia<<内经>>475~221B.C.（2）华

6、陀(141~203)麻沸散（3）AncientEgyptiansusedThecombinationofopiumpoppyandhyoscyamus（4）TheIncasmaybetheearliesttouselocalanesthesia.拦叉脓以纪钞崭质传配坠梦寒坍陕篷乏乃免裂哼炊宅胃餐驯莽卯巫门句喳临床麻醉学临床麻醉学2、Modernanesthesiology（1）InhalationalAnesthesia(吸入麻醉)1844HoracewellsN20(氧化亚氮)△1846WilliamT.G.MortonEther(乙醚)1847JamesSimpsonchlo

7、roform(氯仿)△1920ArthurE.Guedelwasthefirsttoelaborateonthesignsofgeneralanesthesia△MagillEndotrachealintubation(气管内插管)辗煮托杖耍量逗怒克舶拿粳泼琐弗翟彤烩扼恼湃猛缺淄绷昨社轮语济校港临床麻醉学临床麻醉学△1927Ralphwaterssodalime(钠石灰)1956halothane(氟烷)1972enflurane(恩氟烷)1981isoflurane(异氟烷)1