口腔颌面外科学（中山大学）2.局麻与镇痛.pptVIP

Anesthesia in Oral and maxillofacial region , sedation and intensive care口腔颌面外科麻醉、镇痛及重症监护 The third hospital affiliated to SUN YAT-SEN university 蒋立坚 Historical Perspectives 麻醉术出现的意义---人类进入不疼痛的时代 无麻醉的西医外科：病人惨烈无比、医生无比坚强快速；飞刀李斯顿300%死亡率 中国古代对麻醉的贡献：华佗“麻沸散” 口腔医生对麻醉的贡献：莫尔顿用乙醚拔牙 The situation of oral anesthesia口腔麻醉概况 Past Less varieties, ineffective, many complications. Status Anesthetic varieties increase(Product variety),favorable effect, complications were greatly reduced, application of computer. The point of this chapter Local anesthetic, sedation, analgesia. 过去：麻药品种少、效果欠佳、并发症多 现况：麻药品种增加（商品种类多）、效果好、并发症大大减少、计算机的应用 本章的学习重点：局部麻醉、镇静、镇痛 一些概念 麻醉（Anesthesia） 局部麻醉（Local Anesthesia） 全身麻醉（General Anesthesia） 冷冻麻醉（Frozen Anesthesia） 低温麻醉（Hypothermic Anesthesia） 麻醉学 （Anesthesiology） 镇静（Sedation） 镇痛 （Control of pain） ICU Chapter One: Local Anesthesia第一节 局部麻醉（local anesthesia） Local anesthesia is a local state of insensibility to pain produced by hypodermic injection,local application ,or the instillation of an appropriate chemical compound. The agent acting on the protoplasm of the nerve fibers produces a reversible coagulation which prevents painful sensory impulses from being transmitted to the brain. (The pain disappeared but other feeling existed) Usage : outpatient surgery, the diagnosis and treatment of pain, the treatment of tooth disease and periodontal disease, the crown preparation. 局部麻醉:用局部麻醉药暂时阻断机体一定区域内神经末梢和纤维的感觉传导，从而使该区疼痛消失。(痛感消失但其他感觉存在） 用途:门诊手术、疼痛的诊断和治疗、牙体病和牙周病的治疗、修复的牙体预备等 。 Advantage: easy operation, high security, there were no need of special equipment and special care. Weakness: It can not apply to the patient who is not cooperation or with local inflammation. 优点：操作简单，安全性较大，不需特殊设备及特别护理。 缺点：不适用于不合作的病员及局部有炎症的部位。 local anesthesia agents techniques complications 包括三方面内容 1局麻药物（agents） 2局麻方法（techniques） 3并发症（complications） agents Classification ： according to the chemical structure esters: (allergy): procaine