眼科手术麻醉英语教学.pptxVIP

Profile and Demandsfine procedure demands intraocular pressure ( IOP)airwayoculocardiac reflex (OCR)Preoperative Evaluation and Preparationpsychological preparationtreatment of the original diseasestreatment of the co-existing diseasesPremedicationanticholinegics(抗胆碱药):given intramuscularly, have no significant effects on IOP. However, applied topically to the eye may cause mydriasis (瞳孔散大) and may increase IOP.sedatives(镇静药)analgesics(镇痛药)antiemetics(止吐药)Anesthetic Techniques.local anesthesia.general anesthesiaImportant Points in Local AnesthesiaToxicitty of local anestheticscomplications of retrobulbar block (将局麻药注入睫状长、短神经及眼球筋膜囊内 )application of Adrenalinapplication of sedativesOCRImportant Points in General Anesthesiaanesthetics and IOPcareful monitoringsmooth anesthesiaapplication of muscle relaxantsprevention of OCRN2O on IOPQuestionsWhat’s the main cause of exorbitant IOP during ophthalmic operations?What’s OCR and how to treat it?青光眼(glaucoma)病人的术前用药、局麻用药及全麻肌松药应用注意事项？视网膜脱离修补术中,手术需要往玻璃体内注气，应用吸入全麻药应注意些什么？为什么？ THANK youDemandspatient’s cooperation and immobility — perfect sedation and analgesia should be availablle.fixation of the eyeball — relaxation of the orbicularis oculi muscle(眼轮匝肌 ) and extraocular muscles(眼外肌 ) is necessary.IOP (眼内压)1、IOP：the pressure on the eyeball wall exerted by the intraocular contents. 2、aqueous humor circulation3、The main determinant of IOP is the dynamic balance between the production of aqueous humor and its eventual elimination.4、the main cause of exorbitant IOP is the obstruction of the aqueous humor(房水) circulation. Several impact facts on IOP Mydriatic drugs(扩瞳药) Maneuvers (动作行为) Hypercarbia (高碳酸血症) and hypoxia (低氧血症) Pressure on the eyeball Anesthetics:Most anesthetics reduce IOP. Only succinylcholine and ketamine may increase IOP. Oculocardiac Reflex(OCR)眼心反射The OCR is a trigeminovagal reflex(三叉-迷走神经反射) that may be induced by pressure on the eyeball, traction(牵拉) on the extraocular muscle(眼外肌), orbital(眼眶内的) hematoma(血