眼科手术麻醉英语教学课件

Anesthesia

forOphthalmicSurgery

(眼科手术麻醉)

XuliAnesthesia

forOphthalmicSu1眼科手术麻醉英语教学ppt课件2眼科手术麻醉英语教学ppt课件3ProfileandDemandsfineproceduredemands

intraocularpressure(IOP)airwayoculocardiacreflex(OCR)ProfileandDemandsfineproc4PreoperativeEvaluation

andPreparationpsychologicalpreparationtreatmentoftheoriginaldiseasestreatmentoftheco-existingdiseasesPreoperativeEvaluation

andP5Premedicationanticholinegics(抗胆碱药):givenintramuscularly,havenosignificanteffectsonIOP.However,appliedtopicallytotheeyemaycausemydriasis(瞳孔散大)andmayincreaseIOP.sedatives(镇静药)analgesics(镇痛药)antiemetics(止吐药)Premedicationanticholinegics(抗6AnestheticTechniques.localanesthesia.generalanesthesiaAnestheticTechniques.localan7complicationsofretrobulbarblock(将局麻药注入睫状长、短神经及眼球筋膜囊内)ImportantPointsinLocalAnesthesiaapplicationofAdrenalinapplicationofsedativesOCRToxicittyoflocalanestheticscomplicationsofretrobulbarb8ImportantPointsinGeneralAnesthesiacarefulmonitoringsmoothanesthesiaapplicationofmusclerelaxantspreventionofOCRN2OonIOPanestheticsandIOPImportantPointsinGeneralAn9QuestionsWhat’sthemaincauseofexorbitant

IOPduringophthalmicoperations?What’sOCRandhowtotreatit?青光眼(glaucoma)病人的术前用药、局麻用药及全麻肌松药应用注意事项？视网膜脱离修补术中,手术需要往玻璃体内注气，应用吸入全麻药应注意些什么？为什么？QuestionsWhat’sthemaincause10THANKyouTHANKyou11Demandspatient’scooperationandimmobility

—>perfectsedationandanalgesiashouldbeavailablle.fixationoftheeyeball—>relaxationoftheorbicularisoculimuscle(眼轮匝肌)andextraocularmuscles(眼外肌)isnecessary.Demandspatient’scooperationa12IOP(眼内压)1、IOP：thepressureontheeyeballwallexertedbytheintraocularcontents.

3、ThemaindeterminantofIOPisthedynamicbalancebetweentheproductionofaqueoushumoranditseventualelimination.2、aqueoushumor

circulation4、themaincauseofexorbitantIOPistheobstructionoftheaqueoushumor(房水)circulation.

IOP(眼内压)1、IOP：thepressureon13眼科手术麻醉英语教学ppt课件14眼科手术麻醉英语教学ppt课件15SeveralimpactfactsonIOP

Mydriaticdrugs(扩瞳药)

Maneuvers

(动作行为)

Hypercarbia(高碳酸血症)andhypoxia(低氧血症)

Pressureontheeyeball

Anesthetics:MostanestheticsreduceIOP.OnlysuccinylcholineandketaminemayincreaseIOP.SeveralimpactfactsonIOPMy16OculocardiacReflex(OCR)

眼心反射TheOCRisatrigeminovagalreflex(三叉-迷走神经反射)thatmaybeinducedbypressureontheeyeball,traction(牵拉)ontheextraocularmuscle(眼外肌),orbital(眼眶内的)hematoma(血肿),oculartrauma(损伤),andeyepain,manifestedbycardiacarrhythmias(心律失常)suchasbradycardia(心动过缓),nodalrhythm(结性节律),ectopicbeats(异位搏动),ventricularfibrillation(心室纤维颤动),orasystole(心脏停搏).OculocardiacReflex(OCR)

眼心反射T17LocalAnesthesiatopicalanesthesia(表面麻醉)infiltrationanesthesia(浸润麻醉)nerveblock(神经阻滞)LocalAnesthesiatopicalanesth18GeneralAnesthesiawithendotrachealintubationwithoutendotrachealintubationGeneralAnesthesiawithendotra19眼科手术麻醉英语教学ppt课件20AnestheticsandIOP

MostgeneralanestheticsareCNSdepressants,theylowerIOP.

Butsuccinylcholinecausesatransient(4~6min)butsignificantincreaseinIOPof10to20mmHg.TheeffectofketamineonIOPvaries.EarlystudiesreportedanincreaseinIOPafterintramuscularorintravenousadministrationofketamine.Ketaminegivenafterpremedicationwithdiazepamandmeperidine(哌替啶)doesnotaffectIOP,andintramuscularlyadministeredketaminemayevenlowerIOPinchildren.AnestheticsandIOPMostgener21N2OonIOPOphthalmologistssometimesinjectasmallbubbleofgas(e.g.,SF6)intothevitreal(玻璃体的)cavityduringreattachment(修补)oftheretina(视网膜)soastoholdtheretinainplaceunderalong-actingbubbleofstablesize.N2OismorediffusiblethanSF6andmoresolubleinwater,andrapidlyentersthegasbubble.Admin