MindMap Gallery general anesthesia
General anesthesia content of anesthesiology. General anesthesia refers to the entry of anesthetic into the body through respiratory inhalation, intravenous or intramuscular injection, resulting in temporary suppression of the central nervous system. The clinical manifestations include loss of consciousness, loss of systemic pain, amnesia, reflex suppression and skeletal muscle relaxation.
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This is a mind map about plant asexual reproduction, and its main contents include: concept, spore reproduction, vegetative reproduction, tissue culture, and buds. The summary is comprehensive and meticulous, suitable as review materials.
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general anesthesia
General anesthesia classification
inhalation general anesthesia
intravenous general anesthesia
Combined intravenous and inhaled general anesthesia
general anesthetic
inhalation anesthetic
Physical and chemical properties
Blood/gas distribution coefficient (λ blood/gas)
Indicates controllability
λ blood/qi↑medicine enters the blood↓
Oil/gas partition coefficient (fat solubility)
Minimum alveolar effective concentration (MAC)
At one atmospheric pressure, the concentration of drug in the alveolar gas that can eliminate pain in 50% of patients
MAC↓Performance↑
drug
N2O: The inspired oxygen concentration must be maintained above 0.3 to avoid hypoxemia.
Enflurane: Elevated inhaled concentrations may cause epileptiform spikes and burst suppression
Isoflurane: has no significant effect on liver and kidney function
Sevoflurane: can be used for induction and maintenance of anesthesia
Desflurane: "Quick to sleep, quick to wake up", requires special vaporizer
intravenous anesthetic
Ketamine
Can increase cerebral blood flow, intracranial pressure and cerebral metabolic rate
Sympathetic nerve stimulating effect
Mild impact on breathing
Can increase saliva and respiratory secretions
Can cause transient respiratory depression; hallucinations, psychiatric symptoms; increased intraocular pressure and intracranial pressure
etomidate
Propofol
muscle relaxants
Succinylcholine
Vecuronium bromide
Rocuronium
cisatracurium
Precautions when using muscle relaxants
1. An artificial airway should be established and assisted or controlled breathing should be performed
2. Muscle relaxants have no sedative or analgesic effects and cannot be used alone. They should be used under the action of general anesthesia.
3. The application of succinylcholine can cause a temporary increase in serum potassium; therefore, it is contraindicated in patients with severe trauma, burns, paraplegia, glaucoma, and elevated intracranial pressure.
4. Hypothermia can prolong the action time of muscle relaxants
5. Patients with neuromuscular junction diseases are contraindicated in using non-depolarizing muscle relaxants.
6. Some muscle relaxants have the effect of releasing histamine, so those with asthma and allergies should use with caution.
Opioids
Administration of general anesthesia
induce
From waking state to loss of consciousness
induction of inhalation anesthesia
Open drip method (basically abandoned)
Mask inhalation induction
intravenous induction
maintain
Discontinuation of medication from loss of consciousness to completion of surgery
Principle: Sedation, analgesia, muscle relaxation
wake
Stop taking the drug until consciousness is fully restored
Complications and management of general anesthesia
Reflux and aspiration
airway obstruction
Tongue drop is the most common upper respiratory tract obstruction during anesthesia
hypoventilation
hypoxemia
malignant hyperthermia
intraoperative knowledge
Wake-up delay
hypothermia