MindMap Gallery Preparation before anesthesia
This review of pre-anesthesia preparation knowledge in clinical medicine covers its purpose and tasks as well as patient physical and mental preparation. Friends in this major and those who are interested should not miss it.
Edited at 2023-03-06 08:49:13El cáncer de pulmón es un tumor maligno que se origina en la mucosa bronquial o las glándulas de los pulmones. Es uno de los tumores malignos con mayor morbilidad y mortalidad y mayor amenaza para la salud y la vida humana.
La diabetes es una enfermedad crónica con hiperglucemia como signo principal. Es causada principalmente por una disminución en la secreción de insulina causada por una disfunción de las células de los islotes pancreáticos, o porque el cuerpo es insensible a la acción de la insulina (es decir, resistencia a la insulina), o ambas cosas. la glucosa en la sangre es ineficaz para ser utilizada y almacenada.
El sistema digestivo es uno de los nueve sistemas principales del cuerpo humano y es el principal responsable de la ingesta, digestión, absorción y excreción de los alimentos. Consta de dos partes principales: el tracto digestivo y las glándulas digestivas.
El cáncer de pulmón es un tumor maligno que se origina en la mucosa bronquial o las glándulas de los pulmones. Es uno de los tumores malignos con mayor morbilidad y mortalidad y mayor amenaza para la salud y la vida humana.
La diabetes es una enfermedad crónica con hiperglucemia como signo principal. Es causada principalmente por una disminución en la secreción de insulina causada por una disfunción de las células de los islotes pancreáticos, o porque el cuerpo es insensible a la acción de la insulina (es decir, resistencia a la insulina), o ambas cosas. la glucosa en la sangre es ineficaz para ser utilizada y almacenada.
El sistema digestivo es uno de los nueve sistemas principales del cuerpo humano y es el principal responsable de la ingesta, digestión, absorción y excreción de los alimentos. Consta de dos partes principales: el tracto digestivo y las glándulas digestivas.
Preparation before anesthesia
Purpose and tasks
Purpose
The patient is in optimal physical and mental condition
Enhance patient tolerance
Improve safety and avoid anesthesia accidents
Reduce complications after anesthesia
Task
Physical and mental preparation The primary task
Pre-anesthetic medication
Preparation of anesthesia appliances, equipment, monitoring instruments and medicines (including emergency medicines and equipment), etc.
Patient physical and mental preparation
Physical preparation
Improve the patient's overall condition
nutritional status
Correct severe anemia, water, electrolyte and acid-base disorders and hypoalbuminemia
Patients with high fever: lower to below 38.5°C
Actively treat medical diseases
Cardiovascular System
For patients with heart failure, atrial fibrillation or significant heart enlargement: digitalis drug treatment, the drug should be stopped on the day of surgery; atrial fibrillation is accompanied by a fast ventricular rate, digitalis can be administered until the morning of the surgery; long-term use of B-receptor blockade For patients with angina pectoris and arrhythmia, medication should generally be continued until the day of surgery; for essential hypertension: the blood pressure during elective surgery should be at least lowered to below 180/110mmHg. Do not lower the blood pressure of patients with chronic hypertension too quickly; long-term use of antihypertensive drugs Patients: Generally, the medication should be continued until the day of surgery.
respiratory system
Control respiratory infections for 1 week Stop smoking for at least 2 weeks
Central Nervous System
Acute cerebral infarction: surgery should be postponed for 4 to 6 weeks Parkinson's disease: Pulmonary function test; blood gas analysis; guiding patients to exercise; respiratory function; anti-Parkinson's disease drugs should be used until before surgery, and anti-dopa drugs should be avoided.
Endocrine System
Hyperthyroidism: Preoperative preparation generally includes antithyroid drugs and iodine treatment; indicators of adequate preparation before anesthesia: basal metabolic rate <±20%; pulse rate <90 beats/min, reduced pulse pressure; patient's mood is stable and sleeping Good, weight gain, etc. Primary aldosteronism and hypercortisolism: attention should be paid to correcting water, electrolyte and acid-base balance disorders before anesthesia, with special attention to potassium supplementation Pheochromocytoma: Hypertension should be controlled as much as possible before surgery. While using α-blockers to dilate blood vessels, fluid therapy should be actively carried out to expand blood volume. Diabetes: elective surgery is required to control fasting blood sugar below 8.3mmol, preferably within the range of 6.1~7.2mmol/L, with the highest not exceeding 11.1mmol/L; urine sugar is lower than (/1): urinary ketone bodies (1) Short-acting hypoglycemic drugs or those using regular insulin: discontinue use on the morning of surgery Stop taking long-acting hypoglycemic drugs 2 to 3 days before surgery and switch to regular insulin.
Preparation of previous treatments
Antihypertensive drugs, antiarrhythmic drugs, cardiotonic drugs, endocrine drugs, etc. are generally not recommended to be discontinued before surgery.
Monoamine oxidase inhibitors and tricyclic antidepressants need to be discontinued for 2 to 3 weeks.
It is recommended to stop taking aspirin for 1 to 2 weeks until the new platelets can take effect. Use to avoid uncontrollable bleeding during surgery.
Do not drink or fast before anesthesia
Treating a full stomach
Patients with a higher risk of aspiration should fast for more than 8 hours severe trauma(severetrauma) acute abdomen maternal(pregnant) Measures to prevent reflux and aspiration: •Endotracheal intubation •Rapid induction of endotracheal intubation - cricoid cartilage compresses against esophagus •Indwelling gastric tube •Antifoliants, antacids •Attract pretenders •Postural adjustments
mental preparation
The purpose of doctor-patient communication: to relieve fears and concerns; to enhance confidence in overcoming the disease; to sign an anesthesia informed consent form