Case 10. Anesthesia for the "Healthy" Patient
Case Files: Anesthesiology 学习笔记(40)“健康”患者的麻醉1.
Case Files: Anesthesiology 学习笔记(44) “健康”患者的麻醉2.
Case Files: Anesthesiology 学习笔记(45)“健康”患者的麻醉3.
Clinical Pearls
1. The pre-anesthetic evaluation determines the anesthetic plan.
2. Difficult intubations may often be predicted.
3. The excitement stage of anesthesia (Stage II) happens at induction and emergence.
4. Intubation requires an indication.
Case 11. Anesthesia for Emergency Appendectomy
Case Files: Anesthesiology 学习笔记(46) 急诊阑尾切除术的麻醉1.
Case Files: Anesthesiology 学习笔记(47) 急诊阑尾切除术的麻醉2.
Case Files: Anesthesiology 学习笔记(48) 急诊阑尾切除术的麻醉3.
Case Files: Anesthesiology 学习笔记(49) 急诊阑尾切除术的麻醉4.
Clinical Pearls
1. An appendectomy is a surgical emergency.
2. A rapid sequence induction is generally used for patients undergoing anesthesia for emergency surgery, as this is thought to reduce the risk of pulmonary aspiration of gastric contents.
3. The patient's hemodynamic status should be taken into account when choosing an induction agent. Patients who appear to be septic or volume depleted should have appropriate volume resuscitation before the induction of anesthesia.
4. Adequate pain control prior to emergence and in the postoperative period has many advantages and is the hallmark of an approriate anesthetic plan.
Case 12. Anesthesia for Elderly Patients with Hip Fracture
Case Files: Anesthesiology 学习笔记(53)老年髋部骨折手术的麻醉1.
Case Files: Anesthesiology 学习笔记(54) 老年髋部骨折手术的麻醉2.
Case Files: Anesthesiology 学习笔记(55)老年髋部骨折手术的麻醉3.
Clinical Pearls
1. Regional anesthesiology should be considered for as the primary anesthetic for repair of a hip fracture.
2. Regional anesthesia is relatively contraindicated in patients who are anticoagulated and/or receiving antiplatelet therapy.
3. Administrating anesthesia in the geriatric population must be guided by the physiologic changes that accompany the aging process, and which affect almost every major organ system.
4. Postoperative cognitive dysfunction is a major consideration in choosing an anesthetic technique for the elderly.
Case 13. Anesthesia and the Obese Patient
Case Files: Anesthesiology 学习笔记(56)麻醉与肥胖患者1.
Case Files: Anesthesiology 学习笔记(57)麻醉与肥胖患者2.
Case Files: Anesthesiology 学习笔记(58)麻醉与肥胖患者3.
Clinical Pearls
1. Obstructive sleep apnea is extremely common in morbidly obese patients. and can increase the risk for difficult ventilation, intubation, and postoperative respiratory failure. Treatment for OSA should be initiated early, prior to surgery if possible.
2. Pulmonary function and physiology are altered in morbidly obese patients. They desaturate quickly during periods of apnea, so adequate preoxygenation is essential prior to intubation. Rescue airway devices and additional anesthesia personnel should always be immediately available to help with difficult airway management.
3. Obesity modifies both the pharmacokinetics and pharmacodynamics of anesthetic agents. Some agents should be dosed according to total body weight, and others, lean body mass. Insoluble inhalation anesthetics facilitate a more rapid recovery from anesthetia, and are thus favored in obese patients.
4. Given the high incidence of OSA and adverse outcomes amongst morbidly obese patients, appropirate precautions must be taken when discharging patients from the post-anesthesia recovery unit.
Case 14. Anesthesia for lower Lower Extremity Surgery (Peripheral Nerve Block)
Case Files: Anesthesiology 学习笔记(61)下肢手术的麻醉1.
Case Files: Anesthesiology 学习笔记(62)下肢手术的麻醉2.
Case Files: Anesthesiology 学习笔记(63)下肢手术的麻醉3.
Clinical Pearls
1.Knowledge of lower extremity innervation provides the anesthesiologist with several options to obtain .
2. Local anesthetic choices are guided by the expected duration of the operation and the degree of expected pain following the procedure.
3. Patients who require thienopyridine therapy are not generally candidates for neuraxial anesthesia.
合辑来啦 case files: Anesthesiology-case 6-9
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