MindMap Gallery anaesthetization
The end of term is coming soon! And you haven't started reviewing surgery yet. Here is a mind map of "General Introduction to Surgery - Chapter 1 - Anesthesia", which summarizes and categorizes the knowledge in this chapter of anesthesia in detail.
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This is a mind map about bacteria, and its main contents include: overview, morphology, types, structure, reproduction, distribution, application, and expansion. The summary is comprehensive and meticulous, suitable as review materials.
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This is a mind map about the reproductive development of animals, and its main contents include: insects, frogs, birds, sexual reproduction, and asexual reproduction. The summary is comprehensive and meticulous, suitable as review materials.
anaesthetization
Overview
temporary
Preparation and medication before anesthesia
Pre-anesthesia assessment
Evaluate ASA
Preparation before anesthesia
Correct or improve physiological state
Hemoglobin>80g/L
Plasma albumin≥30g/L
<180/100
Quit smoking for 2 weeks
Fasting blood glucose <8.3
psychology
gastrointestinal tract
Fasting for adults 6-8 years old
No water for 2 hours
Anesthetic supplies, drugs, equipment
Anesthetics, first aid equipment, medicines
Premedication
Purpose 5
drug selection
Commonly used medicines
Tranquilizer
hypnotics
labor pain medicine
anticholinergics
general anesthesia
definition
Central Nervous System
Features
Adjustable, fully reversible
general anesthetic
inhalation anesthetic
Physical and chemical properties
minimum alveolar concentration
Oil and gas distribution coefficient
blood gas distribution coefficient
Influencing factors
ventilation
concentration
cardiac output
blood gas distribution coefficient
concentration difference
Commonly used medicines
nitrous oxide
Causes diffuse hypoxia, contraindicated in patients with intestinal obstruction
Sevoflurane
No irritation to the respiratory tract, relaxation of tracheal smooth muscles, low incidence of coughing, and quick awakening Coronavirus
Desflurane
Little impact on circulation, does not increase myocardial sensitivity to exogenous catecholamines Cardiac surgery/non-cardiac surgery for heart patients/outpatient surgery
intravenous anesthetic
advantage
Quick induction, no respiratory tract irritation, no environmental pollution, low incidence of postoperative nausea and vomiting
Commonly used medicines
Ketamine/k powder
Exciting sympathetic nerves (only) and relieving tracheospasm Basic anesthesia for children
etomidate
No analgesic effect, little impact on circulation, mild coronary artery dilation Induction of general anesthesia, frail elderly and critically ill patients
Propofol
Sedation, hypnosis, mild analgesia, single drug anesthesia Significant cardiovascular and respiratory depression Commonly used clinically
midazolam
Preoperative sedation, auxiliary local anesthesia, ICU patient sedation
Levomedetomidine
Reduce opioid dosage
muscle relaxants
Just relax the muscles
Classification
Depolarizing muscle relaxants
Tired of you
Features
Tremor for the first time
No specific antagonist
non-depolarizing muscle relaxants
postcompetitive inhibition
Features
Can be specifically antagonized
Commonly used
Succinylcholine
Causes high blood potassium and arrhythmia
depolarization
Cuverinium bromide
No histamine release, no antivagal ischemic heart disease
Rocuronium
It has a weak muscle relaxant effect and the fastest onset of action. specific antagonist
cisatracurium
Does not cause histamine release
non-depolarizing
Notice
Contraindications
myasthenia gravis
Narcotic analgesics
morphine
Euphoria, addiction,
Respiratory depression
lower blood pressure
Pethidine
Inhibit myocardial contraction
lower blood pressure
Ward
Fentanyl
Extremely strong analgesic, inhibiting breathing, rarely causing hypotension cardiovascular surgery
remifentanil
Ultra-short-acting, dose-dependent respiratory depression
sufentanil
The circulation interference is smaller, cardiovascular surgery
Operation
implement
induce
airway management
Patency: Tongue falling back - mandibular support method
intubation
Depth 4-5cm Central incisor: 18-22cm
complication
Reflux and aspiration
airway obstruction glottis
Upper respiratory tract
mechanical obstruction
Incomplete obstruction
difficulty breathing, snoring
complete obstruction
Inflamed nose, three concave signs
Laryngeal edema
Mild cases: glucocorticoids
Severe cases: tracheal intubation/tracheotomy
laryngospasm
Inspiratory dyspnea, laryngeal sounds
lower respiratory tract
Tracheal spasm, endotracheal tube torsion, foreign body obstruction
Action: Maintain appropriate depth of anesthesia and good oxygenation
Insufficient ventilation Air<60, pure oxygen<90
Anesthesia machine malfunction
diffuse hypoxia
Atelectasis
Pulmonary Edema
Aspiration
hypotension
30%/80
hypertension
30%%/160
Arrhythmia
Premature ventricular contractions: myocardial ischemia
High fever, convulsions, convulsions
Malignant hyperthermia - dantrolene
Local anesthesia
peripheral nerves
Pharmacology
Classification
Esters
Amides
Physical and chemical properties
dissociation constant
Take effect
fat soluble
efficacy
Protein binding rate
Action time
Absorption, distribution and excretion
lungs first
Adverse reactions
toxicity
Prevention and treatment: Mild: Diazepam/Midazolam Convulsions: Thiopental sodium Recurrent convulsions: Succinylcholine Hypotension: ephedrine Slow heart rate: Atropine
allergy
Commonly used medicines
Procaine
Poor penetration local infiltration anesthesia The safe dose is 1g larger
Tetracaine
Strong penetrating power topical anesthesia
lidocaine
Good tissue diffusion and mucosal penetration Nerve blocks and epidural blocks Adults: Topical anesthesia 100mg Local infiltration anesthesia and nerve block 400mg
Bupivacaine
Cardiotoxicity labor analgesia
Ropivacaine
High protein binding rate Labor analgesia and postoperative analgesia
method
topical anesthesia
local infiltration anesthesia
area block
nerve block
brachial plexus block
interscalene groove
shoulder upper limb
supraclavicular
upper limbs
armpit
forearm hand
cervical plexus block
intercostal nerve block
digital nerve block
neuraxial anesthesia
anatomy basics
Mechanism and Physiology
subarachnoid space
L3-4
cerebrospinal fluid
Plane: patient position
sellar area anesthesia
5s/ml
complication
Respiratory depression
Heartbeat depression
feel sick and vomit
After surgery
low pressure headache
urinary retention
Neurological complications: cauda equina syndrome
Indications
Surgery on the lower abdomen, pelvis, lower limbs, perineum and anus within 2-3 hours
epidural block
Depth of judgment
Resistance disappearing method
capillary negative pressure method
Test dose 3-5ml
Plane: Conduit direction
complication
total spinal anesthesia
After surgery
epidural hematoma
Indications
Below the diaphragm, no time limit, Wider than the subarachnoid space
sacral block
Anorectal and perineal surgery