【临床麻醉学教案】妇产科麻醉.doc

【临床麻醉学教案】妇产科麻醉.doc课程名称:临床麻醉授课时间:授课对象:麻醉医学专业教学内容:妇产科麻醉计划学时:4学时重点:孕妇的生理学特点、麻醉药对母体与胎儿的影响、麻醉管理难丿兄高危妊娠产科的麻醉教学H的:使学生拿握孕妇的生理学特点,麻醉药物对母体与胎儿的影响及高危妊娠产科的麻醉管理教学方法教 具:双语讲解、启发、互动、幻灯新内容新知识:M订ler'sanesthesia,6"'Edition,10%夕卜语关键词:Obstetricsanesthesia,hange,placentaltransfer,respiratorydepression,:M订leHsanesthesia,6'11Edition课 堂设 计孕妇的生理学改变20min讲解+幻灯麻醉药物对母体与胎儿的影响麻醉镇痛药15min讲解+幻灯非阿片类屮枢性镇痛药5min讲解+幻灯非巴比妥类镇静安定药15min讲解+幻灯全身麻醉药物15min讲解+幻灯肌松药物10min讲解+幻灯局部麻醉药物15min讲解+幻灯胎盘屏障对麻醉药的影响5min讲解+幻灯产科手术的麻醉10min讲解+幻灯仰卧位低血斥综合征的预防10min讲解+幻灯前置胎盘与胎盘早剥的麻醉15min讲解+幻灯妊娠高血压综合征合并心衰的麻醉10min讲解+幻灯重度妊高征的麻醉15min讲解+幻灯多胎妊娠的麻醉10min讲解+幻灯新生儿窒息与急救评估10min讲解+幻灯新生儿复苏术15min讲解+HANGESOFPREGNANCYCardiovascularSystem:cardiacoutput,heartrateHematologicSystem:bloodvolumeincreasesbyupto45%,redcellvolumeincreasesbyonly30%—physiologicanemiaRespiratorySystem:increaseintherespiratoryminutevolumeandworkofbreathingGastrointestinalSystem:endotrachealintubationRenalSystem:GFRrises50%;glycosuriaCentralNervousSystem::lowmolecularweights,highlipidsolubility,non-ionizedApproximately50%bypassestheliver・MorphinePlacentaltransferisrapidMother:uterusreactivenessJorthostatichypotensionnauseavomitingdelayedgastricemptyingFetus:monlyusedduringlaborintramusculardose: 50TOOmgTimeofIM:beforeexpulsion1hor4huterinecontraction,frequencyan