① Eliminate the patient’s nervousness, anxiety and fear, enhance the effect of general anesthetics, reduce the side effects of general anesthetics, and produce an amnestic effect on adverse stimuli

② Raise the patient's pain threshold, relieve or relieve pain caused by primary disease or invasive procedures before anesthesia

③ Eliminate adverse metabolism caused by surgery or anesthesia, especially vagal reflex, and inhibit sympathetic nerve excitation to maintain hemodynamic stability

④Inhibit gland secretion, anticholinergic drugs, atropine

① General anesthesia, sedation, analgesia ➕ anticholinergic drugs

② Neuraxial anesthesia, sedation ➕Anticholinergic drugs

③When choosing to use propofol and thiopental sodium general anesthesia, a sufficient amount of atropine should be used

④ For patients with coronary heart disease and hypertension, the dosage of sedatives can be increased appropriately; for patients with heart valve disease, poor cardiac function, and severe illness, the dosage of sedatives and analgesics should be reduced.

⑤Those with poor general condition, the elderly and infirm, cachexia, and those with hypothyroidism are very sensitive to hypnotic sedatives and analgesics, and their use should be reduced or avoided.

⑥For young and strong patients or patients with hyperthyroidism, the dosage should be increased.

⑦ Medication before anesthesia, usually intramuscular injection within 30-60 minutes before anesthesia. For those who are nervous, sedative-hypnotics can be taken orally the night before surgery to relieve the patient's nervousness.

Esters

Amides

①Procaine

②Tetracaine

③Lidocaine

④Bupivacaine

⑤ Ropivacaine

toxic effects

Allergic reaction (most people are allergic to ester local anesthetics)

Topical anesthesia: Apply a local anesthetic with strong penetrating power to the surface of the mucosa, allowing it to penetrate the mucosa and block the nerve endings located under the mucosa.

Local infiltration anesthesia: Inject local anesthetic into the tissue of the surgical area to block nerve endings and achieve anesthesia.

Regional anesthesia: Inject local anesthesia around and at the bottom of the surgical site to block the nerve fibers leading to the surgical site.

Nerve block: Inject local anesthetic around nerve trunks, plexuses, and nodes to block their impulse conduction and produce anesthesia in the areas they control.

Spinal anesthesia puncture: generally lie on the side, flex the hips and knees, flex the head and neck toward the chest, and bend the waist and back as far as possible to open the spinous process gap for easy puncture. The puncture point for adults is generally the L3-4 gap, but it can also be used as appropriate. Move up or down

Commonly used drugs for spinal anesthesia: procaine, tetracaine, bupivacaine

Spinal anesthesia plane adjustment

complication

Indications: Suitable for surgery on the lower abdomen, spout, lower limbs and anus and perineum within 2-3 hours

Contraindications

advantage

advantage