全身麻醉的诱导

nyl :3-4µg/kg?Sufentanyl:0.3-0.4µg/kg?Remifentanyl :1-2µg/kgРmuscle ?relaxationРDepolarizing: inycholine?Nondepolarizing: Vecuronium; Atracurium; Pipecuronium; RocuroniumР2 实施原则和药物选择РRapid-sequence Intravenous Induction?(快速诱导)Р顺序给予催眠、安定药或静脉麻醉药及肌松药行气管插管?适用于一般情况好,无呼吸道梗阻,无气管插管困难的病例Р2 实施原则和药物选择Р2 实施原则和药物选择РInduction with spontaneous ventilation?(慢诱导)Р适应症:气道不畅或估计作气管内插管有困难者?要点:保持自主呼吸+表面麻醉Р静脉注射对呼吸无明显抑制的药物使病人入睡或丧失神志,然后作气管内插管?或吸入麻醉诱导再作气管内插管Р● young children ?● myasthenia gravies ?● upper airway obstruction, e.g. Epiglottitis ?● lower airway obstruction with foreign body ?● bronchopleural fistula or empyema (支气管胸膜瘘/脓胸) ?● no accessible veinsРInhalational InductionР2 实施原则和药物选择Р2 实施原则和药物选择РIntravenous induction following ?conscious intubationР适应症:有误吸危险的病人(饱胃)或麻醉下极易出现体位性低血压的病人(如截瘫病人)?要点:完善的表面麻醉+病人的镇静合作