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1 、㈠ CNS
2 、 reversible unconsciousness
3 、 loss of pain and reflexes ,
muscle relaxation ;
4. Used : as an adjunct to surgical
procedures .
1 IntroductionDefinition
history of anesthetics : Physical methods
1 、 strangulation 勒绞法
2 、 blow to the head 棒击法
3 、 packing a limb in the ice 冷冻、
or make it ischemic 放血法
1842 年: Crawford Long ( USA )首次应用乙醚麻醉进行手术,麻醉从此进入历史新纪元。
1847 年: 苏格兰产科医生 James Simpson 首次使产妇吸入氯仿以无痛分娩。
2 inhalational anesthetics
[character]
1 、 highly liposoluble , volatilizatio ,
2、 similarity mechanism of action ;
3 、 obvious stages of anaesthesia.
[ stages of anaesthesia ]
I. Stage of analgesia ;
Ⅱ、 Stage of excitement ;
Ⅲ 、 Stage of surgical anesthesia ;
IV 、 Stage of medullary depression .
Ⅰ、 Stage of analgesia :
anaesthesia beginning
unconsciousness
( loss of painful feel feeling
hearing )
〔 stages of anaesthesia 〕
Ⅱ、 Stage of excitement ; unconsciousness
loss of painful feel
Stage of surgical anesthesia
( Reflexes 、 HR 、 BP 、 pupil )、
involves NO.1 NO.4
Ⅲ、 Stage of surgical anesthesiaexcitement calm
IV 、 Stage of medullary depressio
n .
( BP 、 HR 、 pupil
loss of reflexes )
Process in the body respiratory
tract
lung Blood CNS
brain/blood 分配系数大
脑中浓度高
麻醉深
blood/gas 分配系数大
血中溶解度高
难饱和
不易麻醉
诱导期长
MAC
( minimal alveolar concentration ):
1 ) at 1.01×10 5 Pa
2 ) concentration which results in
analgesia in 50% of patients ,
meaning : 1、 comparison for potency of
general anesthetic agents
MAC anesthetic potency
2 、 MAC = ED50 of
general anesthetic agents
Halothane 氟烷1 、 action : narcotism mightiness ;
2 、 analgesia and muscle relaxation
3 、 no burn , no explode ;
4 、 chemical feature : unstable
Common drugs :
enflurane , isoflurane
[characteristics]
1 、 property stable , safe ;
2 、 anesthetic rapid 、 come to consciousness fast ;
3 intravenous anaesthetics pentothal sodium 硫喷妥钠
characteristics
1 、 anesthetic barbiturates
2 、 highly liposoluble ;
3 、 action transitoriness .
4 、 analgesia ,
muscle relaxation of incompletion ;
Use 1) induction anesthesia 、
2) basal anesthesia ,
3)operation (short term) ;
5 、 ( - ) respiratory ,
note : newborn and infant
Ketamine 氯胺酮
characteristics
1 、 dissociation anaesthesia
1 ) Cerebral function separate 、
2 ) consciousness – feel dissociative
form 。
2 、 anaesthesia action rapid 、
brevity , 3 、 (+) cardiovascular ;
4 、 use : pediatric procedure
prohibit use : hypertention 、
psychosis 。
4. combine with agents of
muscular relaxation
5. hypothermal anesthesia
6.controlled hypotetion
7.neuroleptanalgesia