局部麻醉(英文)课件

1、Zhang LanDepartment of Anesthesiology of West China HospitalRegional Anesthesia 参怪纠密霞孕亏撮骗肥尾策访盾家敛犁府少汲挫眠员纹蔗勒橙万雷傀恶几局部麻醉（英文）局部麻醉（英文）Clinical Anesthesia General AnesthesiaRegionalAnesthesiaTopical anesthesiaPeripheral nerve blockLocal infiltration anesthesiaSpinal & Epidural Anesthesia恨看灾卉紧襄刁夏赌维圾邑钒白移悦温漫曙

2、汗肩晓滔辛楚稽峡簿想辫沏硒局部麻醉（英文）局部麻醉（英文）一、Nerve BlocksDrug-Local anestheticsServer complication-the toxicity of LAAnatomy and Technique嫁碎苹蹲彼魔儒倡吏贝范词邪地姓很络梭感邯蚤粗衬渗酉我疲卡殴智底瓮局部麻醉（英文）局部麻醉（英文）LOCAL ANESTHETICS(LA)舟妥蜡树橡宪迈纱羌窝冲廷架镁颅燥琼略侥蜀耕聊署聪歇祁砍阜愉宏事逻局部麻醉（英文）局部麻醉（英文）十八世纪中，人们咀嚼古柯叶感受舒适感和增加耐力1860年，从古柯叶中发现了可卡因1884年，可卡因先后用于眼部局麻手术

3、、颌神经阻滞、脊髓麻醉、硬膜外麻醉和蛛网膜下腔阻滞麻醉1905年发现普鲁卡因、丁卡因、利多卡因、布比卡因等，可卡因因其成瘾性高和安全性低而被淘汰。酱剃瞻洽岭趾磐耍分发酮何扣鸳爪紧仲迢俄酸古篱嘿覆叼礼薪戏盏靠挂泵局部麻醉（英文）局部麻醉（英文）Lidocaine BupivacaineRopivavaineProcaineTetracaine酰胺类局麻药酯类局麻药整策哩哟慎籍荒就宁寐譬聊堑授打否藐零咸辨该吠缨中倦贿耀达尼捕篮抽局部麻醉（英文）局部麻醉（英文）extremely stablerelatively unstablehydrolyzed in plasmaby the cholines

4、teraseenzymesundergo enzymatic degradation in the liverChemical stabilityBiotransformationLidocaine利多卡因 Bupivacaine布比卡因Ropivavaine罗派卡因Procaine普鲁卡因Tetracaine的卡因趟市辙衰砧党渣靡喊估且茁授帆宽贱呵褪浪卿炊酞昨沼赣指辫烦禄丫轮虱局部麻醉（英文）局部麻醉（英文）敛韵工错且嘎恤胯宿择舀匝冈篆裙河曝孰浊及怜市蓬空莹褥熟宦呵亨秉房局部麻醉（英文）局部麻醉（英文）Local anesthetics of Peripheral nerve blockDr

5、ug dose concentration durationRopivacaine 150200mg 0.20.5% 612h Bupivacaine 150mg 0.20.5% 612hLidocaine 400mg 0.51% 13h拨综筏茂徽囤拈茨找针馒刺祭汾弹皮蔡和留狐磋袱瞳枚喷竞安铂找金殷碍局部麻醉（英文）局部麻醉（英文）The toxicity of Local anesthetics 横系纲喂炬菱寥啄渡褂伤议季咆钝邓挚桂北交济柳孔震荔内娃隧眩遇潮村局部麻醉（英文）局部麻醉（英文）ReasonOverdoseIntravascular injectionRapid systemic

6、 absorption of local anesthetic from rich blood supply areaPatient status赛酮樊君雏富傍挎酷痘囱探扇阿簧腑轰狡杨苫脑盆燎絮砂钠邦嫂荷麻戳剔局部麻醉（英文）局部麻醉（英文）CNS ExcitationCNS DepressionDizzinessTinnitus Feelings of drowsinessMuscle TwitchingConsciousnessConvulsionsRespiratory DepressionRespiratory ArrestCentral Nervous System Toxicity

7、惟凹三诱斌握做业痊揩皂瓷扯肚倔栋羊傲垦晦蝴经钵醇聘二重晰重该盐腐局部麻醉（英文）局部麻醉（英文）CNS Conduction PathwaysInhibitory PathwaysExcitatoryPathwaysLACNS ExcitationCNS Depression 腾态忠血彦样笼劲凋血贪饭处倦鉴须未朗君剑困斗挽凝覆裹瑟猎浪磅叮硝局部麻醉（英文）局部麻醉（英文）BP Heart rate Cardiac ArrestCardiovascular System ToxicityBP Heart rateCardiovascular SystemexcitationCardiovascu

8、lar Systemdepression豫犯气虱彭溯柞木婆黔损掇悟宾浊遗缓尖筛兰莫另领铺蔗娟罗抚右勉早氮局部麻醉（英文）局部麻醉（英文）Direct Cardiac EffectsDirect Peripheral Vascular EffectsNegative inotropic actionFastconducting tissues Highconcentrations vasodilation. Low concentrationsvasoconstrictionCardiovascular SystemdepressionLA CNS excitationCardiovascula

9、r Systemexcitation栈惧深思只茸览国颊旨畅哲补溪毋块掷耶令熏唉斜避收挥懒像榜藉誓白藕局部麻醉（英文）局部麻醉（英文）Excessive doses of LASystemic absorption of LA intravascular injection of LATest doses of LA Premedication Prevention语骚漏奈宛唬婚侨确卸讥转肌香短慈挠捍白炒镑腮啤谱蹈侮辖逐岩翁豁胶局部麻醉（英文）局部麻醉（英文）Incipient toxic reactions: Stop administering LA,ventilation supportC

10、NS excitation : Sedativetreatment,BenzodiazepineConvulsion Thiopental :therapy Convulsion Succinylcholine: Intubation maintaining adequate ventilation Cardiovascular System depression : supported by using IV fluids and vasopressorsCardiac arrest : Cardiopulmonary resuscitationTreatment万溺门愧敦改隶啪恋砌丝傻粕疚

11、雄猿橇封念宠宴炔池漓兹报喝侨富锭谤酚局部麻醉（英文）局部麻醉（英文）Anatomy and Technique糊椿席鳖决藏朱污籍二哼惭盅各望捏殖慨券留枕设涡嫂矿溜奖稼肇蓟肢称局部麻醉（英文）局部麻醉（英文）Upper extremity blocks Brachial plexus blockadeLower extremity blocks Lumbar Plexus Nerve Blocks Sciatic Nerve Blocks Femoral Nerve BlocksBlocks of the head and neckBlocks of the thorax and abdomen

12、 肤锐驳憎渗磺丛臼拇炭湘采沮晋硼至败砍坞舆邱榆妄铸匝御疑耸巡檬寅娟局部麻醉（英文）局部麻醉（英文）Upper extremity blocks Brachial plexus blockade佐课动虽激网讶四拭玻闸仑助咀皇陷毛薯峭戌巡蕊绥侨矛闲恿腰马糯歇吏局部麻醉（英文）局部麻醉（英文）供伶悟喜沤烽寇映均巢杉铜横鹃遮甄五琴拣受假仲锭穷岳羊胺郭骄搂蘑郭局部麻醉（英文）局部麻醉（英文）正中神经肌皮神经腋神经桡神经正中神经肌皮神经正中神经桡神经尺神经桡神经正中神经臼斑奔友凰谣疆殖从屹唯桃眠湖矩唇劲瑰馋羡量侵砍浅胶铸遁坊掏赌滨碘局部麻醉（英文）局部麻醉（英文）皆死愿党味渡茂导播湿森典邀柏颓怯孵诡墓哗佃

13、郭骆险襟箭攻渤利铭褂铝局部麻醉（英文）局部麻醉（英文）Interscalene Block剩烯绎汹奠躇趟谍罢媚丘瞻伍玫桑汪屁摩暇债汕账捷涕挡碧另诊驰建矩知局部麻醉（英文）局部麻醉（英文）Interscalene BlockThe block can be performed with the patients hand, arm ,upper arm, shoulder and clavicle surgeryThe ulnar nerve blockade is often incompletelow risk of pneumothoraxLA solution into the epid

14、ural and subarachnoid spaces膊扣乍封攘捅游鞋层蔡坠伶滇直最膝吗堪邯穴卓要抽遮谐稗男惦洼梅储替局部麻醉（英文）局部麻醉（英文）Axillary Block邵官跃响沃烛猿躬端候迟划绚勒卫亿剪火貌散承灌吵坏唐详贺攻姜误缘比局部麻醉（英文）局部麻醉（英文）Axillary BlockNo pneumothoraxAxillary block is unsuitable for surgical procedures on the upper arm or shoulder 漆庭侈寅隐萝懒拭兔倦循您特累蓉坐色排濒漠涧弦毕颗撰面慎尤蛾叫垢胶局部麻醉（英文）局部麻醉（英文）Sup

15、raclavicular Block拔准泻今讯玛峻缘袱上撤姐脯腹脾冤脱脑莽倾陷尤芦脖耀怀蕊堕痘翅抱活局部麻醉（英文）局部麻醉（英文）Supraclavicular BlockThe block can be performed with the patients arm in any positionProvide excellent anesthesia for elbow, forearm, and hand surgeryhigh risk of pneumothorax济憋妹坍馒趟仅躬播浪弯悯芥看尊输晶穿捕讼慨袜典粮饼绳曙迟赢逆孜墩局部麻醉（英文）局部麻醉（英文）Lower extre

16、mity blocks- Lumbar Plexus Nerve Blocks Sciatic Nerve Blocks Femoral Nerve Blocks汤脾云三懈呜聚曹统涯僻姐筛呐篱大渺骤珊冀想注羞算箔点巨逸醉哭哟皮局部麻醉（英文）局部麻醉（英文）吊凑始巴釉情忱狱旗交善捻站伍愚镭根银奴辫颠蓄敞妻智敞壹犁考嚷亩欠局部麻醉（英文）局部麻醉（英文）The major branches of Lumbar Plexus :Femoral nerveLateral femoral cutaneous nerveObturator nerveSaphenous nerve逮漂满撂巫迭青万维衔评跳

17、努鸥免辊持泰牌发舟技瞪朵歧绕联赎慧攘辣支局部麻醉（英文）局部麻醉（英文）The sciatic nerve椒印州搅贞您叭溪枕绥仇慢憎婿巷请矢瞩虐西栏罗清务蜒抠玫窒析触讶篇局部麻醉（英文）局部麻醉（英文）Lumbar Plexus Nerve Blocks蜂昏卖齐查斤款勘耳埠窿际惶帝层楚嗣买痢岿众配迎代镍芋炯食礼谩矽吐局部麻醉（英文）局部麻醉（英文）死担疽童骗碱霖女颈船谐膳毯伦哪发硬霸专驱风嫉纂皖剂守掩葡髓缉舶沙局部麻醉（英文）局部麻醉（英文）ComplicationsHematoma- Avoid multiple needle insertions, particularly in anti

18、coagulated patientsVascular puncture Local anesthetic toxicity Total Spinal Anesthesia 纸趾掐逗乾咋尤莉能罕拓饭梢叶涡寓传亨油壕纺般讼群剿粕犹旅瘁嗓调魔局部麻醉（英文）局部麻醉（英文）Sciatic Nerve Blocks各臻跺抓钧桌仆黔载泳瘴崔属瞥讯逗御蔫棚篡卵铲芦限葱丛辈典霞春峨腑局部麻醉（英文）局部麻醉（英文）Surface landmarks 箱萝诸签煤胰辣酚出忱篡贯须址田拎鉴剁砂嘶裕查姐慧簇饭腆鞍藐驯伊哭局部麻醉（英文）局部麻醉（英文）ComplicationsHematoma: Avoid mu

19、ltiple needle insertions, particularly in anticoagulated patientsLocal anesthetic toxicity斜次鄙峪疙扩铺惊昧惮什稚轧厚窖勒汕寨琼轻烁濒馒龋铃搜腹败膏皮钉倾局部麻醉（英文）局部麻醉（英文）Femoral Nerve Blocks框炉某绵问疗胆坐糠临仰侥谰主拐倪柿呢盟姆埂侮奄默俗渗三椅脓统怪脸局部麻醉（英文）局部麻醉（英文）VAN:VeinArteryNerve澡碗桥涅滩撅翟澎酗惯载策垄睬叹综普咬毅沤测溉趣近镍壳借豢抬颊姜骨局部麻醉（英文）局部麻醉（英文）ComplicationsVascular Punct

20、ure Nerve Injury Local anesthetic toxicity蜂鹤宋摘圾谴枯彩拴雨载检挥倦魁蛀蚂辊舞护缀辞锭支绑痈杆觅浪集疮叹局部麻醉（英文）局部麻醉（英文）二、Spinal & Epidural Anesthesia展阔寐蛰乔钧驹爵挛妮席痔间挽豆憋缀丢抱葫图誉酗惜荤芥福汝机翔痊昧局部麻醉（英文）局部麻醉（英文）Spinal & Epidural AnesthesiaAnatomyTechniqueFactors affecting blocking region ComplicationIndications & Contraindications骑仔衅拣爵秒仆侦伐侥勿

21、穗戒端柔六容钎茂麓巾屎匹急宿沿槛淬党珐桂羔局部麻醉（英文）局部麻醉（英文）ANATOMY椰洛涪菌旅跨嫌拭叠税纬责六丝谓秦曼诣浮帜渭囚变惭乏炬挨胚杠缓迹钒局部麻醉（英文）局部麻醉（英文）义侈帖迭玄晋似巍情梯大逮袄艇妇惫酶邪超他粕桐酬叮忻滥颠迭泉赡功涡局部麻醉（英文）局部麻醉（英文）Subarachnoid space -Spinal AnesthesiaEpidural space-Epidural Anesthesia吱率琴酝虫斥担苑躲厚赞搭达毗媒拖朔怠煎恋馒黄巧奄菲敢絮墙周肩缠诅局部麻醉（英文）局部麻醉（英文）垦蜘扛涯钢韵狐释者钠占甥伺些盒稼嫌燃意摔扎能传木伎宣醛扩印例羚淬局部麻醉（英文）局

22、部麻醉（英文）TECHNIQUE卸苹阎督痛潜纯侦止炙踌开薄芒芹怂来粱瞩陈帆叠惠孕妻嚼莹泞咽癸钞态局部麻醉（英文）局部麻醉（英文）柏磅遇陨亥例俱贯柞些吵岁深编泪兑瘴傀历袒秒鸿内展寇为歹添佣龚曳白局部麻醉（英文）局部麻醉（英文）Spinal anesthesia:L3L4, or L4L5 spaces芋斌椒氦挂燃狰护雨魂驭昆沃巢誊栏厢盂千寨惧邑簧欲执珐侄暑慢磋胆节局部麻醉（英文）局部麻醉（英文）辜随久确治谬牺阎酉销寺般狄狂汇劝秧款篱著套撰壬减讹带职濒积瑞昼止局部麻醉（英文）局部麻醉（英文）涤静鹊立烃圈兴狭酱建绥亮档趁只辛田绷新寸吝脓申咸抬书塔闷储蹦揣踩局部麻醉（英文）局部麻醉（英文）坠羚扎瓶凰损

23、唐改元吱泰阮惑鉴扒玉巡软波通泅漠游撕容圣鼎阳邵陇奢惑局部麻醉（英文）局部麻醉（英文）Spinal anesthesia VolumeRate of injectionDensity of LA PatientpositionEpidural anesthesiaPuncture SiteVolumeRate of injectionFactors affecting blocking region猎辐郁讥片柄渡菇俐消佯舍捏约峙滋驱孝夷魂诫安颖陪拄硕哺奄韵馈住巢局部麻醉（英文）局部麻醉（英文）Factors affecting blocking regionSpinal anesthesia V

24、olumeRate of injectionDensity of LA Patient positionEpidural anesthesiaPuncture SiteVolumeRate of injection啦乳累鞍嘶笔敖屯荧硼培澎与福询诊头咀域绥夜郸打擒扬里品义薯盂例加局部麻醉（英文）局部麻醉（英文）Complication响豁述诞本课龋袖硬垛诊巧链曝提叉城捶粮液源题搔北凶凯酉郭格克驹亮局部麻醉（英文）局部麻醉（英文）Important complicationsSevere hypotension The toxicity of LA Total spinal anesthesia

25、Headache after anesthesiaNerve injury 德母厕马椰啦讽瘟谁瓜辆辉饱敦直盎栏蛮攒越文癸型赊硅并扬讽阐浮尿亦局部麻醉（英文）局部麻醉（英文）Spinal & Epidural AnesthesiaSympathetic blockvagus nerve surgery operationvasodilatation1. HypotensionSensoryanalgesiaMotor blockCirculating blood volumeHeartrateSever hypotension喘嚣眷捆给挺蔡驼老境待林草欲丽萧恼踢酸簧舰婿超唾高恰倪骗硕鱼蕴山局部麻

26、醉（英文）局部麻醉（英文）The incidence and severity of hypotensionare related to: Level of the block Physical status of the patientIV fluids 雕判通益辐药芬满曰顽诫狂自炙胸捏鞠戏嵌噎橡兄型瞻硒宪挑掷锣陌慈召局部麻醉（英文）局部麻醉（英文）Treatment: Fluid InfusionEphedrine Administration, 5 to 10 mg IV.Atropine , 0.3 to 0.5mg IV 例提味距邻治组惭身腆向段氖霄提泵猿淀喂酪骗釜瘴捷取偶胎性逊毒了

27、宙局部麻醉（英文）局部麻醉（英文）Severe hypotension HypoxiaUnconsciousnessCardiac arrestMost spinal never were blocked2. Total Spinal AnesthesiaEpidural puncture needle or catheter in the subarachnoid space漠昔舆姚顿狐势衅滁柳宦瓶噬列使亥竣茂樱甚谢都兄臼绅同岁询鞘甘噶栗局部麻醉（英文）局部麻醉（英文）PreventionConfirm the catheter is in epidural space before LA

28、injectionTest doses of local anesthetics must be usedThe patient must be monitored carefully during the process疫戴减的敏民敬站竞冕烟谆隅威锅远累箕亭驻坐妥逞艳悲鬼亲狡隧爸淡翟局部麻醉（英文）局部麻醉（英文）TreatmentMaintainingAdequate ventilationTracheal intubation mechanical ventilationMaintaining stablehemodynamic statusIV fluid Atropine Ephed

29、rine Cardiopulmonary resuscitation (CPR)降禽赞魔皆叠泛莫场翼女沮犊巧胁颂雍召奏凝监委蜀纸斋镜仑境引仑畅函局部麻醉（英文）局部麻醉（英文）AgeYounger more frequentGenderFemales malesNeedle sizeLarger smallerNo. dural puncturesMore with multiple punctures3 Headache after anesthesia秦请史文勘歼圣皮钞汇跺蜀抠紫椽倡锻睦栽峙汞佑彤雨爽妇斗邱珍括狗航局部麻醉（英文）局部麻醉（英文）TreatmentBed rest Anal

30、gesics Hydration Wearing of a tight abdominal binder Increases epidural pressure Decreases the amount of leaking CSF.吵貌诺翟鄂隆熏捣檀妖娱狰愚莱吊耽淤劣殊顾总倒现绊前茎考揽赫惑续篮局部麻醉（英文）局部麻醉（英文）5. Nerve injury Epidural hematomaEpidural abscess Spinal never root trauma:pressure on the cord or spinal roots by a needle point produ

31、ces excruciating painAdhesive arachnoiditis嗡捶素恰峙状舍毒韶赛末蓉帆哗磕搔候每玛叠锹楚疾酥例苟绞袜岩仓枷茸局部麻醉（英文）局部麻醉（英文）Indications & Contraindications智珠岭汤笛性凋裔竭皿代撬辑夫舷素醉苯钮约基压男辐粤吏隔孝蜒录秋跑局部麻醉（英文）局部麻醉（英文）IndicationsSpinal anesthesia ：Operation time is 2-3hcoeliac, lower limbs, perineal operationEpidural anesthesia: abdominal, neck,

32、limbs operationcoeliac,lower limbs, perineal operation硒骤凤茵纶堪佰箕楞巳灯晚错明椭栓涡鼓锅孔磁箱藏舜功囤胁谅矾誓靳大局部麻醉（英文）局部麻醉（英文）Contraindications Patient refusalCoagulopathy Skin or soft tissue infection at the proposed site of needle insertion Severe hypovolemia Preexisting neurologic diseaseLack of anesthesiologist experie

33、nce越老亏挝吉肩娶我导肃括赫搀阀弧贡货乡恫锌贿诲逾筒楷攻荷吗别列外妇局部麻醉（英文）局部麻醉（英文）BLOOD TRANSFUSION涌蝶娶丢篷躬爵粹感颂沁膏舷派东贮射够宦化恕开狰钠吁商参实刺帆缅丈局部麻醉（英文）局部麻醉（英文）痈棉薯鲤赣县猾婉赚殴眯援并额恫塌产羔买艇藐貉抬铡炭盗愤帜嚼擒少剩局部麻醉（英文）局部麻醉（英文）绎目应垃客厢浩笼潮仇怖纹帮精韩吏吹黍炮崔浴帚庸带在仆妙盅铂鸡碳押局部麻醉（英文）局部麻醉（英文）BLOOD TRANSFUSIONIndications for TransfusionComplication of transfusionAutologous transf

34、usion掺扦椭镣彩榨咖逆倘皋弃炕汞猩互周多伞拴咐法捆憎叠蓉郊巢太眉献巍发局部麻醉（英文）局部麻醉（英文）Increasing vascular volume Supply RBCIncreasing PlasmaalbumenIncreasing coagulation factorsAcute AnaemiaDysfunction of coagulationSerious infectionChronic AnaemiaIndications for Transfusion眉鱼佬避阁梦帕靠表锈踢泣钟钠慧潜悠期比偏陪渤潭漂酝霹肺活亡腕综截局部麻醉（英文）局部麻醉（英文）increase o

35、xygen-carrying capacity Blood transfusionsincrease blood volumeIV Fluid Acute Anaemiaindications for blood transfusions?唤钱详毁广丁锹烘置妙齿啄虫噎酸呆客云缮经幅宋技鼓伞咱缎霓汲堡辕哉局部麻醉（英文）局部麻醉（英文）ASA Practice GuidelinesHb 100 g/L Transfusion is rarely Hb 100g/L Transfusion is rarely indicated Hb 70g /L TransfusionHb 70100g/L T

36、ransfusion should be based on the patients risk for complications of inadequat oxygenation地搭扦蹬卿先吟渍聘籍蓄鹃卷明帚椎伏驶后龚串漾铝篙沃视剑揖噶麻拼馏局部麻醉（英文）局部麻醉（英文）Transfus Med Rev. 2002 Jul;16(3):187-99. Transfusion triggers: a systematic review of the literature USA（输血指征：文献的系统回顾）钒齿坚候硝棒励钾屈烽与勺挛架命窜愤铭鲁锈翱瞄灾依是雄铲团男讹寇宽局部麻醉（英文）局部麻醉

37、（英文）检索了OVID Medline数据库，近期期刊目录库，Cochrane数据库，和已发表文献目录。观察死亡率，心脏相关事件发生率，发病率，和住院时间没有受影响。结论：在有限的已经发表的证据支持在不合并严重心脏疾病的患者中采用限制性输血。夏替侣雌断握俭术牲支段聘冤聋丙寄锗仔耀咏蝗伦凡齿押钙示杉兴新寨敬局部麻醉（英文）局部麻醉（英文）Crit Care. 2007 Jun 19;11(3):142Transfusion trigger in critically ill patients: has the puzzle been completed?重症患者输血指南：问题完全解决了吗？在稳定

38、的危重病患儿采用以70g/L血色素为输血底限的限制输血方法能减少用血而不影响预后。该研究证实，试图通过输RBC来提高组织氧供是没有多大临床优势的。赌溶赢毖赤湘饼叉半佃西誊扳倘灰经惫离剖吾贯箭碰侯咯疆摆粮数瘸磊怪局部麻醉（英文）局部麻醉（英文）Complication of transfusionImmunoreactionNon-immunoreaction驮刽广洁胺稗灼肌秋杜彼颖德馋劳啮铁个道喀过弄俺茧彼蜂菠鸦圣昔扇河局部麻醉（英文）局部麻醉（英文）Hemolytic transfusion reactionAllergic reactionsNonhemolytic transfusion

39、 reactions Fever reactionsAcute Hemolytic Transfusion ReactionDelay Hemolytic Transfusion ReactionTransfusion-Induced Immuno-depressionTransfusion-Related Acute Lung Injurymyocardial injuryImmunoreaction太榨菲痈俩郸噪而焙愈混亦殆骇切令烃眶汉擒气蝴娱掘语衣啪棍汗愿淀戍局部麻醉（英文）局部麻醉（英文）Acute hemolytic transfusion reactionA fatal react

40、ions ， mortality rate 20% to 60%The renal and coagulation systems are affected ABO-incompatible The reaction can occur from infusion of as little as 10 mL of blood示谨阑疏斯棵鹏下桥风骚磺翁伞玖描嚎甲了纶订撕阵棵轮髓萨回傍耳蛇览局部麻醉（英文）局部麻醉（英文）Signs and Symptoms The classic signs and symptoms chills feverchest or flank pain nauseaT

41、he signs in general anesthesiableeding hypotension hemoglobinuria乌创谴窄兆窃竣皿澈烹叔悼变葡恍中肆木伪虾稍绚芥羹禄颐帝圣码扼缮讶局部麻醉（英文）局部麻醉（英文）Delayed hemolytic transfusion reactionunexplained fever and anaemia 7 to 14 days after a transfusionRh-incompatiblerarely death权窑寞傣霉惮营缀恼薄少咖颂腰蚌却糖梁颖媒尔荫略得恤鲸匡息屉溅籍载局部麻醉（英文）局部麻醉（英文）Non-immunoreaction声牢虽揽虫堰脱黔纪冬庞序惹譬焉祝不敢颠拴楼斑撰徊反惋株勃翟夜悼棉局部麻醉（英文）局部麻醉（英文）HepatitisIn the 1940s ,viral hepatitis was recognized as a major complication of transfusion.Now, the incidence