《静脉全麻》PPT课件

《《静脉全麻》PPT课件》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。

1、第八章静脉全身麻醉Intravenousanesthesia1.IntroductionDefinitionGeneralanesthesiamaybeproducedbymanydrugswhichareadministeredviaintravenousinjectionanddepressthecentralnervoussystem.●Rapidinductionofanesthesia●Non-irritanttotherespiratorytract●Noenvironmentalpollution●Makin

2、gpatientcomfortable●Rapidrecovery●SimplytouseAdvantages●Nomusclerelaxation●Poorcontrol●PooranalgesiaDisadvantages●Intravenousbasalanesthesia●Intravenousinductionofanesthesia●IntravenousmaintenanceofanesthesiaClassifications●Bolusinductionofanesthesia,minoroperatio

3、n●Intermittentinjection●Continuousinfusion●Target-controlledinfusion(TCI)Methods2.IntravenousAnesthesiaofThiopentoneSodiumMethods①Bolus（2-2.5%）◆shortproceduresorinductionofanesthesia●adults:2.5—4.5mg/kg●youngchildren:5-6mg/kg●elder:2.5-3mg/kg◆Basalanesthesiaforch

4、ildren:●2.5%,15-20mg/kg,i.m----inducesleepin5min●5-10%,44mg/kg,rectaladministration----inducesleepin10-15min②intermittentinjection●首次3-5ml，递增5-10ml，意识消失，睫毛反射消失，疼痛刺激无反应，开始手术●每2-3分钟，注药1-2ml●成人总量≤0.5g，最大剂量0.75-1.0g③Continuousinfusion●辅助麻醉，解痉、控制惊厥●0.1%-0.5%，20-100滴/分钟

5、滴注●蓄积、中毒Indications●Induction●Maintenance●Basalnarcosis●Treatmentofstatusepilepticusandconvulsion●Assistantofotheranesthesia●ReductionofintracranialpressureAbsoluteContraindications●Airwayobstruction●Porphyria●PrevioushypersensitivingreactionPrecautions●Cardiovasc

6、ulardisease(hypovolaemia,myocardialdisease,cardiacvalvularstenosis)●Severehepaticdisease●Renaldisease●Muscledisease●ReducedmetabolicratePrecautions●Obstetrics●Outpatientanesthesia●Adrenocorticalinsufficiency●Extremesofage(neonate,infant)●AsthmaComplications●Phlebi

7、tis●Tissuenecrosis●Intra-arteryinjection:endarteritis●Severecardiovascularandrespiratorydepression●Allergicreaction●Laryngealspasm●Bronchospasm●Coughingandhiccups3.IntravenousAnesthesiaofKetamineMethods①肌肉注射法(intramuscularinjection)●Children4-6mg/kg，<1yearincreas

8、edto10mg/kg●1-5min起效，维持15-25分钟●追加首量1/2—1/3②静脉注射法（intravenousinjection）●首量1-2mg/kg，1-2min起效，维持5-10min●追加：首量的1/2或全量●总量<6mg/kg③连续静脉输注法（continuousintravenou