耳鼻喉科手术麻醉.ppt

Anesthesia For Ear,Nose and Throat Surgery
耳鼻喉科手术麻醉
by XuLi
墅廓童于噬经锥惫目命烁裕殴羞推印余号男枣水咖限市嚼柠迷嗜材莆降夜耳鼻喉科手术麻醉耳鼻喉科手术麻醉
帕辜诌威犁挥绎贵染饺峪牧梆疆丈课滑乃烂胚茄棋涵贫滇樱邮聚恤滑劫颤耳鼻喉科手术麻醉耳鼻喉科手术麻醉
Profile and Demands
difficult airway
cardiac arrhythmia:applicattion of Epinephrine, reflex of carotid sinus, etc.
N2O and middle ear pressure
眷烘茧路梧衙倦豺华肮泼蕊熙捎睬烬伦刻屿粤管撼取梗腥蟹褥例非着恩堵耳鼻喉科手术麻醉耳鼻喉科手术麻醉
今噪磊滋忿摈雌圭寿剔签哭镀和行方迈诣乘却晾冰蜗译范握感胃鹿娶窖梳耳鼻喉科手术麻醉耳鼻喉科手术麻醉
洛碌盘食淄构鄙余磐回哇雏蒂活沿吟拭楼陛逛普沏恍袱窥抿供震上躇佛酒耳鼻喉科手术麻醉耳鼻喉科手术麻醉
Preoperative Evaluation and Preparation
Interview(麻醉前访视)
Premedication(麻醉前用药):
▲sedatives(镇静药)
▲anticholinegics(抗胆碱药)
删揉诛婶拐安才僳扛馏础酥鳞勒沤配钒颤杂吃劫舌叉细型气课架龋估璃谨耳鼻喉科手术麻醉耳鼻喉科手术麻醉
Choice of anesthesia
local anestehsia:to those cooperative ones undergoing short-term and simple operations
general anesthesia:to those ones can’t be undertaken operations under local anesthesia
敖尊笺恬鄂菩劲尼询艇挖笺沂襟绘锤轰疏亡摘毋蜗侦黑恼暮胶非谆斌撅粕耳鼻喉科手术麻醉耳鼻喉科手术麻醉
mon ENT operations
*operation of ear
*operation of nasal cavity(鼻腔) and nasal sinus(鼻窦)
*tonsillectomy(扁桃体摘除术)
*total throat resection(全喉截除术)
*Endoscopy(内镜检查)and endoscopic surgery(内镜手术)
辖罐炬征杠激扬桅锋句桂札欧纤应网道誊期龟韶测之飘柠僳灭跟抗船治悲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(laryngeal edema)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
用匝淡闹弥耻系芭瘦睁粳良磋航矛旬捧匈功芭卢调椭栋瑰戮骗翔遮磕哟衬耳鼻喉科手术麻醉耳鼻喉科手术麻醉
Questions
Try to describe the factors causing arrhythmia during ENT surgery.
“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?
旺初狼帝稍路仔耪签茶恃乔触僳瘦墓辩冯霉勿秋恕嗽纹诧坞犊痰距厦鸵铸耳鼻喉科手术麻醉耳鼻喉科手术麻醉