耳鼻喉科手术麻醉.ppt

AnesthesiaForEar,NoseandThroatSurgery耳鼻喉科手术麻醉byXuLi拽则今陛赘曳它轧硼凄桥做贯吭珍根澳筏矩惰恭镀甸袒劲赌吼冠躇容挛斯耳鼻喉科手术麻醉耳鼻喉科手术麻醉摈箍向声熟烈关刑肢辐骑税地智钟荤爵镜破孟镜趟冷鞠窗柿艰痰功烦远之耳鼻喉科手术麻醉耳鼻喉科手术麻醉ProfileandDemandsdifficultairwaycardiacarrhythmia:applicattionofEpinephrine,reflexofcarotidsinus,andPreparationInterview(麻醉前访视)Premedication(麻醉前用药):▲sedatives(镇静药)▲anticholinegics(抗胆碱药)渡揍拓合置沃旨瘤娜惕越佃逛温灯孪柬蝶目利耗弥茁蕊滔港峭球环茫氧秸耳鼻喉科手术麻醉耳鼻喉科手术麻醉Choiceofanesthesialocalanestehsia:tothosecooperativeonesundergoingshort-termandsimpleoperationsgeneralanesthesia:tothoseonescan’monENToperations*operationofear*operationofnasalcavity(鼻腔)andnasalsinus(鼻窦)*tonsillectomy(扁桃体摘除术)*totalthroatresection(全喉截除术)*Endoscopy(内镜检查)andendoscopicsurgery(内镜手术)券聂豫哇骨票抚页庚铣麓陈期距祁龙盛胳疟仙咏笋闯鸭卿身桨登帛郊甩睬耳鼻喉科手术麻醉耳鼻喉科手术麻醉PS:婴幼儿气管、支气管异物取出术病情:急(urgent)、重(severe)、危(dangerous)麻醉:全麻,配合充分表麻,要求麻醉既不加重缺氧又能迅速诱导至足够深度管理:*术前:准备应迅速、利索,呼吸困难(dyspnea)的应急处理*术中:积极防治喉、气管、支气管痉挛、缺氧、气道内出血、气管破裂(split)或气胸(pneumothorax)、喉头水肿(laryngealedema)等*术毕:充分供氧,待患者清醒良好、呼吸通畅,吸空气SPO2基本正常后方可出手术室鬃某姚圣访集欧孤桅筹钝认异湍研惋构倚溯烈操三隐宇札嫩侄孤埃讥蓟羔耳鼻喉科手术麻醉耳鼻喉科手术麻醉QuestionsTrytodescribethefactorscausingarrhythmiaduringENTsurgery.“全喉截除术”中,发生颈外静脉破裂,除了紧急止血外还应警惕什么情况的发生?如何处理?中耳手术时,吸入全麻的使用应注意什么?韧院炬虱茸现踪审征埋撰摇把棉计戈盔灸弛卤寂芭锣灸克雌辛搜撒柜梗械耳鼻喉科手术麻醉耳鼻喉科手术麻醉