麻醉 英文幻灯 - 副本
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局部麻醉(英文)PPT课件
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。
酰胺类局麻药
Lidocaine Bupivacaine Ropivavaine
酯类局麻药
Procaine Tetracaine
Chemical stability Biotransformation
• high risk of pneumothorax
Lower extremity blocks-
Lumbar Plexus Nerve Blocks Sciatic Nerve Blocks Femoral Nerve Blocks
• The major branches of Lumbar Plexus :
• Cardiovascular System depression : supported by using IV fluids and vasopressors
• Cardiac arrest : Cardiopulmonary resuscitation
Anatomy and Technique
•Epidural anesthesia •Puncture Site •Volume •Rate of injection
※Complication
Important complications
Severe hypotension The toxicity of LA Total spinal anesthesia Headache after anesthesia
• CNS excitation : Sedativetreatment,Benzodiazepine
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。
酰胺类局麻药
Lidocaine Bupivacaine Ropivavaine
酯类局麻药
Procaine Tetracaine
Chemical stability Biotransformation
• high risk of pneumothorax
Lower extremity blocks-
Lumbar Plexus Nerve Blocks Sciatic Nerve Blocks Femoral Nerve Blocks
• The major branches of Lumbar Plexus :
• Cardiovascular System depression : supported by using IV fluids and vasopressors
• Cardiac arrest : Cardiopulmonary resuscitation
Anatomy and Technique
•Epidural anesthesia •Puncture Site •Volume •Rate of injection
※Complication
Important complications
Severe hypotension The toxicity of LA Total spinal anesthesia Headache after anesthesia
• CNS excitation : Sedativetreatment,Benzodiazepine
剖宫产的麻醉(英文版) PPT
been fed
Pregnancy- Hepatic/Renal
Overall liver function generally well maintained
GFR increases by as much as 60%, so BUN and Cr should be lower than normal
So hypoventilation induces hypoxemia and hypercapnia more readily
Pregnancy - GI
LES tone decreased, more risk of regurgitation
Therefore, also more risk of aspiration Since it is an emergency-patient may have
Pregnancy - CV
Decreased peripheral vascular resistance (estrogens) leads to increased CO while BP remains the same
Large uterus and dorsal recumbency can decrease venous return, CO, and uterine and renal blood flow
– Physical condition of mother usually less than optimal
Drugs should be chosen to minimize fetal depression
Decrease time fry
– Decreases fetal exposure to drugs – Decreases maternal cardio/pul depression
Pregnancy- Hepatic/Renal
Overall liver function generally well maintained
GFR increases by as much as 60%, so BUN and Cr should be lower than normal
So hypoventilation induces hypoxemia and hypercapnia more readily
Pregnancy - GI
LES tone decreased, more risk of regurgitation
Therefore, also more risk of aspiration Since it is an emergency-patient may have
Pregnancy - CV
Decreased peripheral vascular resistance (estrogens) leads to increased CO while BP remains the same
Large uterus and dorsal recumbency can decrease venous return, CO, and uterine and renal blood flow
– Physical condition of mother usually less than optimal
Drugs should be chosen to minimize fetal depression
Decrease time fry
– Decreases fetal exposure to drugs – Decreases maternal cardio/pul depression
麻醉PPT课件
管内最有效、最直接的指标 5．纤维气管镜可见气管环或气管隆突
局部麻醉
局部麻醉
【概念】
局麻药——阻滞神经末梢 （干、丛、节）
——局限性感觉、运动消失 【分类】
表面麻醉、局部浸润麻醉、区域阻滞、神经阻滞、 椎管内麻醉
局部麻醉
【优点】神志清醒、生理干扰小、 并发症少、方法简便
【缺点】止痛局限、不完善、 不能满足很多手术需要
全身麻醉——药物及药理学
常用静脉全麻药：
• 氯胺酮（ketamine）
抑制丘脑新皮质系统和大脑联络系统，兴奋延髓和边缘系统。 “分离麻醉”——僵直、浅镇静、遗忘与显著镇痛 优点：镇痛效能强、呼吸循环抑制轻微，不抑制保护性反射 缺点：精神症状、升高眼压颅压肺动脉压
全身麻醉——药物及药理学
常用静脉全麻药：
全身麻醉——药物及药理学
肌肉松弛药：（muscle relaxants）
• 药理：作用于突触后膜乙酰胆碱受体 • 特点：麻痹而不麻醉 • 分类：去极化肌松药、非去极化肌松药
全身麻醉——器械和麻醉机
麻醉机
其它设备
单腔深静脉穿刺包 双腔深静脉穿刺包 Swan-Ganz导管
纤支镜
血液回收机
食道超声 视可尼
椎管内麻醉——腰麻
腰麻（spinal anesthesia)
适应证 1、下腹部、下肢、会阴部手术。 2、手术时间不超过2-4小时。
全 身 麻 醉——分 类
分类：
• 吸入全身麻醉 • 静脉全身麻醉 • 静吸复合全身麻醉
全身麻醉——药物及药理学
分类：
催眠药 镇痛药 肌松药
吸入性催眠药：乙醚，七氟醚，氧化亚氮 静脉催眠药：硫喷妥钠，氯胺酮，异丙酚
吗啡，芬太尼，氯胺酮等
局部麻醉
局部麻醉
【概念】
局麻药——阻滞神经末梢 （干、丛、节）
——局限性感觉、运动消失 【分类】
表面麻醉、局部浸润麻醉、区域阻滞、神经阻滞、 椎管内麻醉
局部麻醉
【优点】神志清醒、生理干扰小、 并发症少、方法简便
【缺点】止痛局限、不完善、 不能满足很多手术需要
全身麻醉——药物及药理学
常用静脉全麻药：
• 氯胺酮（ketamine）
抑制丘脑新皮质系统和大脑联络系统，兴奋延髓和边缘系统。 “分离麻醉”——僵直、浅镇静、遗忘与显著镇痛 优点：镇痛效能强、呼吸循环抑制轻微，不抑制保护性反射 缺点：精神症状、升高眼压颅压肺动脉压
全身麻醉——药物及药理学
常用静脉全麻药：
全身麻醉——药物及药理学
肌肉松弛药：（muscle relaxants）
• 药理：作用于突触后膜乙酰胆碱受体 • 特点：麻痹而不麻醉 • 分类：去极化肌松药、非去极化肌松药
全身麻醉——器械和麻醉机
麻醉机
其它设备
单腔深静脉穿刺包 双腔深静脉穿刺包 Swan-Ganz导管
纤支镜
血液回收机
食道超声 视可尼
椎管内麻醉——腰麻
腰麻（spinal anesthesia)
适应证 1、下腹部、下肢、会阴部手术。 2、手术时间不超过2-4小时。
全 身 麻 醉——分 类
分类：
• 吸入全身麻醉 • 静脉全身麻醉 • 静吸复合全身麻醉
全身麻醉——药物及药理学
分类：
催眠药 镇痛药 肌松药
吸入性催眠药：乙醚，七氟醚，氧化亚氮 静脉催眠药：硫喷妥钠，氯胺酮，异丙酚
吗啡，芬太尼，氯胺酮等
麻醉护理ppt课件
• 催眠药：(巴比妥)鲁米那钠。镇静、催眠、 抗惊厥及防治局麻药毒性反应。
• 镇痛药：哌替啶和吗啡。镇痛镇静及减少 麻醉药用量
• 抗胆碱药：东莨菪碱、阿托品。阻断M胆 碱能受体作用
全身麻醉 general anesthesia
• 吸入麻醉inhalation anesthesia • 麻醉药经呼吸道吸入而产生的全麻
常用肌松药
• 去极化肌松药 琥珀胆碱
• 非去极化肌松药 潘库溴铵、维库溴铵（仙林）、哌库 溴铵(阿端）、罗库溴铵、阿曲库铵、 美维松
麻醉辅助用药
• 安定(Diazepam):
起效慢，维持时间长；用量不足有烦躁 作用；有遗忘作用；主要应用于长时间的手 术麻醉。
• 咪唑安定(Midazolam):
起效快，维持时间短；有遗忘作用；主 要应用于诱导。
率正常，潮气量＞5ml/kg; • 6.30分钟内未用镇痛药及呼吸抑制药
.７口腔鼻腔及气管内无分泌物 • 8.循环稳定 • 9.引流液不多，无二次进手术室止血的可能
全身麻醉的常见并发症及处理
一呼吸系统 1.上呼吸道梗阻 A.舌后坠:提下颌、置口咽通气道 B.喉痉挛：减少刺激、保证供氧，必要时插管 C.喉头水肿：激素应用 2.通气不足 多见于麻醉药物的残余作用 3.低氧血症（ PaO2〈60mmHg） 辅助或控制呼吸 二循环系统 4.低血压：快速输注晶体或胶体 5.高血压：去处原因，降压 6.心律失常 三其它 7.躁动 8.苏醒延迟 9.恶心呕吐
• (常规术前8小时禁食 、2小时禁饮，预防麻醉后食物反 流引起窒息
2. 术前用药
麻醉后护理
麻• 吸醉氧恢复期的监测和管理
• 监测:连接多功能监护仪，Spo2.BP； ECG.T.CVP.PetCo2.PCWP
• 镇痛药：哌替啶和吗啡。镇痛镇静及减少 麻醉药用量
• 抗胆碱药：东莨菪碱、阿托品。阻断M胆 碱能受体作用
全身麻醉 general anesthesia
• 吸入麻醉inhalation anesthesia • 麻醉药经呼吸道吸入而产生的全麻
常用肌松药
• 去极化肌松药 琥珀胆碱
• 非去极化肌松药 潘库溴铵、维库溴铵（仙林）、哌库 溴铵(阿端）、罗库溴铵、阿曲库铵、 美维松
麻醉辅助用药
• 安定(Diazepam):
起效慢，维持时间长；用量不足有烦躁 作用；有遗忘作用；主要应用于长时间的手 术麻醉。
• 咪唑安定(Midazolam):
起效快，维持时间短；有遗忘作用；主 要应用于诱导。
率正常，潮气量＞5ml/kg; • 6.30分钟内未用镇痛药及呼吸抑制药
.７口腔鼻腔及气管内无分泌物 • 8.循环稳定 • 9.引流液不多，无二次进手术室止血的可能
全身麻醉的常见并发症及处理
一呼吸系统 1.上呼吸道梗阻 A.舌后坠:提下颌、置口咽通气道 B.喉痉挛：减少刺激、保证供氧，必要时插管 C.喉头水肿：激素应用 2.通气不足 多见于麻醉药物的残余作用 3.低氧血症（ PaO2〈60mmHg） 辅助或控制呼吸 二循环系统 4.低血压：快速输注晶体或胶体 5.高血压：去处原因，降压 6.心律失常 三其它 7.躁动 8.苏醒延迟 9.恶心呕吐
• (常规术前8小时禁食 、2小时禁饮，预防麻醉后食物反 流引起窒息
2. 术前用药
麻醉后护理
麻• 吸醉氧恢复期的监测和管理
• 监测:连接多功能监护仪，Spo2.BP； ECG.T.CVP.PetCo2.PCWP
麻醉概述英文ppt课件
常见心律失常心电图诊断的误区诺如 病毒感 染的防 控知识 介绍责 任那些 事浅谈 用人单 位承担 的社会 保险法 律责任 和案例 分析现 代农业 示范工 程设施 红地球 葡萄栽 培培训 材料
Contents
1. The history of anesthesiology 2. The scope of anesthesiology 3. Classification of Anesthesia 4. Definition of Anesthesia 5. Preparing for anesthesia
Purposes of the preoperative visit
1. Establish rapport with the patient 2. Obtain a history and perform a physical
examinations 3. Order a special investigations 4. Assess the risks of anesthesia and
• Muscle relaxants resulted in evolution of anesthesiology---Curare(箭毒)was firstly used in 1942
常见心律失常心电图诊断的误区诺如 病毒感 染的防 控知识 介绍责 任那些 事浅谈 用人单 位承担 的社会 保险法 律责任 和案例 分析现 代农业 示范工 程设施 红地球 葡萄栽 培培训 材料
examination, laboratory evaluation • Preoperative fasting • Coexisting disease therapy • Equipment preparation • Preoperative medication
麻醉概述局部麻醉PPT课件
编辑版ppt
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二、临床麻醉方法分类
基础麻醉:麻醉前使病人进入类似睡眠 状态，以利于其后麻醉处理,这种麻醉前 的处理称为基础麻醉。
麻醉方法总的发展趋势是全身麻醉 占有率逐年递增，原则是采用复合用药 或方法降低各种不良反应对机体的影响， 使麻醉深度适中，既满足手术要求又易
于调控和恢复。
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根据麻醉药作用于神经系统的部位不 同或合并使用药物不同，将其分为：
（一）：全身麻醉(General anesthesia)
（二）：局部麻醉(Local anesthesia)
（三）：椎管内阻滞(Intrathecal block) （四）：复合麻醉(Combined anesthesia) （五）：基础麻醉(basal anesthesia)
普丁 利
布罗
理化性质
pka
8.9 8.5 7.9
8.1 8.1
脂溶性
低高 中
高高
蛋白结合率％ 5.8 75.6 64.3 95.6 94
麻醉性能
效能
弱强 中
强强
弥散性能
弱弱 强
中中
起效时间
慢慢 快
中中
作用时间（h） 0.75-1 2-3 1-2
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一、麻醉前准备 （preoperative prepare）
（一）医护方面： 1、病情估计：
访视病人：病史、体检、特殊检查
评估标准：目前采用美国麻醉医师协 会制订的ASA病情分级
根据评估制订麻醉方案
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美国麻醉医师协会病情评估分级
（the ASA physical status scale）
麻醉学PPT课件
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LOGO
吸入麻醉药
❖ 最低肺泡有效浓度（minimum alveolar concentration MAC） 指某种吸入麻醉药在一个大气压下与纯氧同时吸入时，能使
50％病人在切皮时不发生摇头、四肢运动等反应时的最低肺泡浓 度。
❖ 代谢性和毒性 ▪ 脂溶性较大，绝大部分由呼吸道排出 ▪ 体内代谢主要在肝 ▪ 代谢率越低，毒性越低
❖ 胃肠道的准备 ▪ 成人择期手术禁食8小时，禁饮4小时 ▪ 小儿术前禁食（奶）4～8小时，禁水2～3小时 ▪ 急症病人
14
LOGO
麻醉前准备事项
❖ 麻醉设备、用具、及药品的准备
▪ 麻醉机 ▪ 监护仪 ▪ 药品 ▪ 麻醉插管用具
15
LOGO
❖ 临床表现为 (1)神志消失 (2)全身痛觉丧失 (3)遗忘、反射抑制 (4)一定程度的肌肉松弛
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LOGO
全身麻醉药
❖ 吸入麻醉药(inhaled anesthetics) ❖ 静脉麻醉药(intravenous anesthetics) ❖ 肌肉松弛药(muscle relaxants) ❖ 麻醉辅助用药(Anesthetics assistant )
21
LOGO
麻醉辅助用药
❖ 镇痛 ▪ 吗啡 ▪ 芬太尼
❖ 镇静 ▪ 咪唑安定 ▪ 安定
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LOGO
麻醉机
❖ 气源 ❖ 蒸发器（vaporizer） ❖ 呼吸回路系统
▪ 开放式 ▪ 半紧闭或半开放 ▪ 紧闭式 ❖ 麻醉呼吸器（ventilator）
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LOGO
静脉麻醉药
❖ 优点
▪ 诱导快 ▪ 无呼吸道刺激 ▪ 无环境污染 ▪ 无需特殊设备
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剖宫产的麻醉(英文幻灯)
Pregnancy - CV
z Decreased
peripheral vascular resistance (estrogens) leads to increased CO while BP remains the same z Large uterus and dorsal recumbency can decrease venous return, CO, and uterine and renal blood flow
Anesthetic Techniques
z Epidural z Systemic
medications z Line block z Inhalant
Neonatal Resucitation
z Clear
head/oropharynx of fluid
– Suction – Swinging/flinging
z Rub
with towel and stimulate z Keep warm z Doxapram z Intubate and ventilate PRN
Pregnancy - Pulmonary
z Oxygen
consumption increases by 20% because of fetus, placenta, uterine muscle and mammary tissue z FRC of lung decreases by anterior displacement of diaphragm and abdominal organs by gravid uterus z So hypoventilation induces hypoxemia and hypercapnia more readily
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(1) Anesthetic requirements may be increased or
decreased. (2) Neuromuscular blockade from muscle relaxants may be enhanced. (3) Cardiovascular response to sympathomimetics and anesthetics may be exaggerated.
Barbiturates, benzodiazepines, Narcotics H2 receptor antagonists Anticholinergics such as atropine or scopolamine
Selection of Anesthesia
Many factors
Smoking and alcohol are well-know factors
influencing anesthetic requirement.
boretory Tests
Advisability Necessary
Questionnaires
E.Summary
1.to make certain that the patient is in optimal
Increasing assessment and accountability
Anesthetic risk is extremely low Anesthetic risk is difficult to ascertain in
most cases.
PREOPERATIVE PROCEDURES ASSOCIATED WITH ANESTHESIA
Preparation for Administration of Anesthesia
Selection of Preoperative Medication
Aim
(1) to relieve anxiety and provide sedation (2) to induce amnesia (3) to decrease secretion of saliva and gastric juices (4) to elevate the gastric Ph (5) to prevent allergic reactions to anesthetic drugs.
Perioperative evaluation for anesthetic risk
Perioperative complication Concurrent disease
Байду номын сангаас
Complexity of the operation
Adverse effects of anesthesia
1903 Baeyer
Phenobarbital
1898
August Bier
spinal anesthetic
1942
Griffith and Johnson
curare
Anesthesiology
Clinical Anesthesia
PCA ICU
CPCR
PREOPERATIVE PROCEDURES ASSOCIATED WITH ANESTHESIA
B. History and Physical Examination
History: allergic reactions, delayed awekening,
prolonged paralysis from neuromuscular blocking
Concurrent diseases ,endocrine abnormalities
ANESTHESIA
Gulisitan Department of Anesthesiology First Affiliated Hospital of Xinjiang Medical University
Contents
History and Risk
Preoprative Procedures Preoperative Management Management of Anesthesia Postoperative Procedures Ambulatory Surgery
History
华佗 ——唐、宋、明、清
（扁鹊）
麻醉学教研室
新疆医科大学第一临床医学院
William Morton and the Fist Successful Demonstration of Anaesthesia
麻醉学教研室
新疆医科大学第一临床医学院
William T . Morton（1919～1868） ——公开演示乙醚麻醉（1846年10月16
麻醉学教研室
Face mask(1847)
Local anesthetics
1884：Cocaine as ophthalmic anesthesia, nerve block 1885：Epidural anesthesia
1898: Spinal anesthesia
1901：Caudal anesthesia 1905：Procaine 1930：Dibucaine 1932：Dicaine
focus on the cardiovascular system, lungs, and,heart rate,blood pressure.
airway, head,neck Mallampati classification:grade 1(easy intubation),grade4 the hard palate is visible but not soft palate.
E
Patient requires emergency operation.
ASA
A、Method and Site of Evaluations
The night before surgery in the
hospital
By telephone(low risk) One or more days(higher risk)
Complications
Risks of Personnel
Definition of Anesthesiology
Anesthesiology is a science which is involved in the study and management of perioperative patients including pre-, intra- and post-operative.
(4) Peripheral sympathetic nervous system activity
may be reduced,and cardiovascular depressant
reactions to anesthetics may be augmented.
(5) Metabolism may be enhanced or impaired.
The purpose of anaesthesia
To keep a patient alive
Free from pain Produse the best possible conditions for surgery
Classification anesthesia
1.local anesthesia
Ⅲ
Ⅳ Ⅴ
Patient has severe systemic disturbance
Patient has severe systemic disturbance that is lifethreatening Patient is moribund and has little chance for survival, but surgery is to be performed
Class
Ⅰ Ⅱ
Physical Status
Patient has no organic, physiologic, biochemical, or psychiatric disturbance. Patient has mild to moderate systemic disturbance
C. Evaluation of Concurrent Drug Therapy
Antiarrhythmics Antibiotics Antihypertensive drug Tricirclic antidepressants Antiarrhvthmic drugs
Mechanisms by which drugs may influence the effects of anesthesia
site of surgery positioning of the patient elective or emergency surgery, full stomach. coexisting diseases age preferences of the patient Pain management
B. History and Physical Examination
Have you had any thing eat or drink 6hour serious illness ,operation heart disease cold,upper airway
B. History and Physical Examination.
Informed Consent
Preoperative medication Anticipated time of transport to the operating room Sequence of events prior to induction Anticipated duration of surgery Description of where awakening from Presence of catheters Likelihood of postoperative nausea and vomiting Magnitude of postoperative pain Whether they will receive blood transfusions
decreased. (2) Neuromuscular blockade from muscle relaxants may be enhanced. (3) Cardiovascular response to sympathomimetics and anesthetics may be exaggerated.
Barbiturates, benzodiazepines, Narcotics H2 receptor antagonists Anticholinergics such as atropine or scopolamine
Selection of Anesthesia
Many factors
Smoking and alcohol are well-know factors
influencing anesthetic requirement.
boretory Tests
Advisability Necessary
Questionnaires
E.Summary
1.to make certain that the patient is in optimal
Increasing assessment and accountability
Anesthetic risk is extremely low Anesthetic risk is difficult to ascertain in
most cases.
PREOPERATIVE PROCEDURES ASSOCIATED WITH ANESTHESIA
Preparation for Administration of Anesthesia
Selection of Preoperative Medication
Aim
(1) to relieve anxiety and provide sedation (2) to induce amnesia (3) to decrease secretion of saliva and gastric juices (4) to elevate the gastric Ph (5) to prevent allergic reactions to anesthetic drugs.
Perioperative evaluation for anesthetic risk
Perioperative complication Concurrent disease
Байду номын сангаас
Complexity of the operation
Adverse effects of anesthesia
1903 Baeyer
Phenobarbital
1898
August Bier
spinal anesthetic
1942
Griffith and Johnson
curare
Anesthesiology
Clinical Anesthesia
PCA ICU
CPCR
PREOPERATIVE PROCEDURES ASSOCIATED WITH ANESTHESIA
B. History and Physical Examination
History: allergic reactions, delayed awekening,
prolonged paralysis from neuromuscular blocking
Concurrent diseases ,endocrine abnormalities
ANESTHESIA
Gulisitan Department of Anesthesiology First Affiliated Hospital of Xinjiang Medical University
Contents
History and Risk
Preoprative Procedures Preoperative Management Management of Anesthesia Postoperative Procedures Ambulatory Surgery
History
华佗 ——唐、宋、明、清
（扁鹊）
麻醉学教研室
新疆医科大学第一临床医学院
William Morton and the Fist Successful Demonstration of Anaesthesia
麻醉学教研室
新疆医科大学第一临床医学院
William T . Morton（1919～1868） ——公开演示乙醚麻醉（1846年10月16
麻醉学教研室
Face mask(1847)
Local anesthetics
1884：Cocaine as ophthalmic anesthesia, nerve block 1885：Epidural anesthesia
1898: Spinal anesthesia
1901：Caudal anesthesia 1905：Procaine 1930：Dibucaine 1932：Dicaine
focus on the cardiovascular system, lungs, and,heart rate,blood pressure.
airway, head,neck Mallampati classification:grade 1(easy intubation),grade4 the hard palate is visible but not soft palate.
E
Patient requires emergency operation.
ASA
A、Method and Site of Evaluations
The night before surgery in the
hospital
By telephone(low risk) One or more days(higher risk)
Complications
Risks of Personnel
Definition of Anesthesiology
Anesthesiology is a science which is involved in the study and management of perioperative patients including pre-, intra- and post-operative.
(4) Peripheral sympathetic nervous system activity
may be reduced,and cardiovascular depressant
reactions to anesthetics may be augmented.
(5) Metabolism may be enhanced or impaired.
The purpose of anaesthesia
To keep a patient alive
Free from pain Produse the best possible conditions for surgery
Classification anesthesia
1.local anesthesia
Ⅲ
Ⅳ Ⅴ
Patient has severe systemic disturbance
Patient has severe systemic disturbance that is lifethreatening Patient is moribund and has little chance for survival, but surgery is to be performed
Class
Ⅰ Ⅱ
Physical Status
Patient has no organic, physiologic, biochemical, or psychiatric disturbance. Patient has mild to moderate systemic disturbance
C. Evaluation of Concurrent Drug Therapy
Antiarrhythmics Antibiotics Antihypertensive drug Tricirclic antidepressants Antiarrhvthmic drugs
Mechanisms by which drugs may influence the effects of anesthesia
site of surgery positioning of the patient elective or emergency surgery, full stomach. coexisting diseases age preferences of the patient Pain management
B. History and Physical Examination
Have you had any thing eat or drink 6hour serious illness ,operation heart disease cold,upper airway
B. History and Physical Examination.
Informed Consent
Preoperative medication Anticipated time of transport to the operating room Sequence of events prior to induction Anticipated duration of surgery Description of where awakening from Presence of catheters Likelihood of postoperative nausea and vomiting Magnitude of postoperative pain Whether they will receive blood transfusions