[There is a certain type of anesthetic]_Type_Classification
Before the operation, anesthesia injection is performed to make the operation go smoothly. The anesthetics used by doctors are different, but the final results are similar. So how many kinds of anesthesias?
There are two types of anesthesia, one is local anesthesia, and the other is general anesthesia, that is, the operation ends after a sleep, which is very beneficial for major surgery.
There are dozens of common anesthetics such as nitrous oxide, naphthalene, and halothane.
1. What are general anesthetics? (1) Common drugs for general anesthesia 1. Anesthetic diol is a colorless, clear and volatile liquid with specific odor, flammable and explosive, and easily oxidized to produce peroxides and acetaldehyde.Increases toxicity.
Anesthesia concentration of ether has little effect on respiratory function and blood pressure, and has little toxicity to the heart, liver and kidneys.
Uncle still has arrow poison-like effect, so muscle relaxation effect is reset.
However, the induction and wake-up complications of this drug are prone to accidents and are rarely used.
2. Halothane is a colorless transparent liquid with a boiling point of 50.
2 ° C, non-combustible and non-explosive, but with uniform chemical properties.
The MAC of Halothane is limited to 0.
75%, strong anesthesia, and small blood / gas distribution coefficient, so short induction period and quick wake up, but weak muscle relaxation and analgesic effect of halothane; expand cerebral blood vessels, increase intracranial pressure; increase myocardiumSensitivity to catecholamines, induced cardiac arrhythmia, etc.
Repeated application of occasional hepatitis or liver necrosis should be vigilant.
Uterine muscle relaxation often causes postpartum hemorrhage, increasing in patients with difficult or caesarean sections.
3. Enflurane and isoflurane are isomers. Compared with halothane, the MAC is slightly larger, the induction of anesthesia is smooth, rapid and comfortable, the awakening is fast, the muscle is easy to be good, and it does not increase the sensitivity to theophyllineSex.
Repeated use without obvious abnormalities, occasional nausea and vomiting.
Is currently the most commonly used inhalation anesthetic.
4. Nitrous oxide, also known as laughing gas, is a colorless, sweet, non-irritating liquid gas, stable in nature, non-flammable and non-explosive.
When used for anesthesia, the patient feels comfortable and happy, has a strong analgesic effect, wakes up quickly after stopping the drug, and has no adverse effects on breathing, liver and kidney function.
But it has a slight inhibitory effect on the myocardium.
The MAC value of nitrous oxide exceeds 100, and the anesthesia efficacy is very low.
The anesthetic effect needs to be compatible with other anesthetics.
The blood / gas distribution coefficient is low and the induction period is short.
It is mainly used for inducing anesthesia or compatible with other general anesthetics.
(2) Intravenous anesthetics are also called non-inhalation general anesthetics. Such drugs are directly injected intravenously. They have a rapid anesthetic effect, have no irritation to the respiratory tract, have fewer adverse reactions, and are easy to use.
 因麻醉较浅，主要用于诱导麻醉。If applied alone, it is only suitable for minor surgery and certain surgical procedures.
ThiopentaI sodium belongs to the ultra-short-acting barbiturates and is the most commonly used anesthetic inducer.
High fat solubility, fast anesthesia effect, but short duration of effect, coupled with poor analgesic effect, incomplete muscle relaxation, it is mainly used clinically for induction anesthesia, basic anesthesia and short-term minor surgery.
Ketamine (Ketamine) is the only non-barbital intravenous anesthetic that has analgesic properties and can be used for induction and maintenance of anesthesia.
It is an NMDA receptor antagonist, which can interrupt pain metastasis and stimulate brain stem and limbic system at the same time, causing pain to disappear and part of consciousness to exist.
 对心血管具有明显兴奋作用。Clinically, it is mainly used for minor surface surgery.
Etomidate is a fast-hypnotic, ultra-short-acting intravenous anesthetic that is mainly used for induction of anesthesia.
The efficacy is fast and the duration is short. Its intensity is about 12 times that of thiopental sodium. Anesthesia occurs about 20 seconds after intravenous injection.
This product has little effect on the cardiovascular and respiratory system, and is suitable for the elderly and patients with cardiovascular disease.
Large doses of rapid intravenous injection of this product may have respiratory depression.
After applying this product, array contractile muscle contraction may occur, and nausea and vomiting may appear during recovery.
Therefore, nausea is prone to occur, and patients who vomit should not be replaced.Propofol is the most commonly used short-acting intravenous anesthetic. It has a rapid onset of action, short duration of action, rapid wake-up, no stimulation to the respiratory tract, and can reduce brain metabolic rate and intracranial pressure.
For general anesthesia induction, maintenance anesthesia and sedation and hypnosis auxiliary medication.
The main adverse reactions are the inhibitory effects on the cardiovascular and respiratory systems. If the injection is too fast, breathing and / or cardiac arrest may occur, and blood pressure may drop.
Sodium hydroxybutyrate has little effect on cardiovascular and is suitable for anesthesia in elderly, children and neurosurgery, trauma and burn patients.
It is widely distributed in the body after intravenous injection, so it has a slower onset of action and a shorter duration of action.
This product can cause delirium and muscle twitch when used alone or by injection too fast. In severe cases, breathing stops.
Fewer patients with severe hypertension, cardiac atrioventricular block, and epilepsy.
(3) Compound Anesthesia Compound anesthesia refers to the application of two or more anesthetic drugs or other auxiliary drugs at the same time or in succession to prevent the patient’s nervousness and overcome the shortcomings of long induction period and incomplete skeletal muscle relaxation of general anesthetic drugs.
(1) Designation before anesthesia refers to the application of drugs before the patient enters the operating room.
(2) Basic narcotics For people who are overly stressed or uncooperative (such as children), use high-dose hypnotics before entering the operating room to make them into deep sleep or light anesthesia.
Inhale anesthetic after entering the operating room.
(3) Induction anesthesia Use thiopental sodium or nitrous oxide with a short induction period to quickly enter the surgical anesthesia period, and then use other drugs to maintain anesthesia.
(4) Low temperature anesthesia combined with the application of chloropropane on the basis of physical cooling, which reduces the body temperature to 28-30 ° C, reduces the oxygen consumption of life organs such as the heart, and facilitates open heart surgery.
(5) Controlled hypotension and short-acting vasodilator sodium nitroprusside or calcium antagonist can moderately lower blood pressure and raise the surgical site to reduce bleeding.
Commonly used in craniocerebral surgery.
(6) Neuroleptic analgesia is commonly used for intravenous injection of a mixture of fluorophenylridol and fentanyl at a ratio of 50: 1.
Suitable for minor surgical operations.
If simultaneous addition of nitrous oxide and muscle relaxant can achieve satisfactory surgical anesthesia, called neuroleptic anesthesia.