Anesthesia was induced with 5% isoflurane in O2, and maintained with 2% isoflurane in O2 during the operation.
用含氧的5%异氟醚进行麻醉，手术中用含氧的2%异氟醚维持麻醉效果。
what is the reason ofthe headache after spinal anesthesia ?
腰麻后头痛的原因是什么？
Caution should be used when performing neuraxial techniques in patients who have recently discontinued chronic warfarin anticoagulation.
Warfarin use should be discontinued for 4 to 5 days before delivery and a normal prothrombin time (PT)/INR documented before initiation of neuraxial blockade.
Simultaneous use of other anticoagulant medications (NSAIDs, UFH, LMWH) can increase the bleeding risk without affecting the PT/INR.
If an epidural catheter is left indwelling and oral anticoagulation is initiated
Monitor the patient’s PT/INR daily before catheter removal.
Neuraxial catheters should be removed when the INR is <1.5.
Neurologic testing of sensory and motor function performed routinely during epidural analgesia and for at least 24 hours after catheter removal.
_________近期停用华法林患者实施椎管内麻醉需及其谨慎。
必须在停用华法林4天～5天后，且凝血功能检查国际标准化比率（PT/INR）正常时方可实施椎管内麻醉。
同时使用其他抗凝剂（NSAIDs、肝素、低分子量肝素）不影响国际标准化比率却增加出血的风险。
如果已经留置了硬膜外导管，同时已经开始口服华法林：
1.拔出硬膜外导管前每天监测国际标准化比率（PT/INR）
2.在INR<1.5时方可拔出椎管内导管
3.在导管留置期间和拔除导管后至少24h内必须监测感觉、运动功能
I lost myself
我撸死了我自己
avoiding common anesthesia errors 避免麻醉中常见错误
麻醉前用药很关键
Premedication is very important。
出自----临床麻醉学 第二版
无搏动电活动
pulseless electrical activity
In epidural anesthesia, local anesthetic to add fentanyl（50~100ug） or sufentanil（12~20ug） able to improve the patient's surgery.
在硬膜外麻醉时，若在局部麻醉剂中添加芬太尼(50~100ug)或舒芬太尼（12~20ug）能改善患者的术中状态。
出自 米勒麻醉学产科麻醉
麻醉最难的不是处理多难多重的病人 而是你把一件最简单的事情重复一万次，而不出错。
The most difficult thing in anesthesia is notto deal withcritically ill patients, but repeating the most simple thingsa million times without error.
——偶然看到的一位老师说的话 觉得很有道理感受颇深 我翻译得不好希望大家也来试试
The fundamental pharmacokinetic processes are dilution into volumes of distribution and clearance. These processes are governed by the physical properties of the drug and the metabolic capacity of the patient. Anesthetic drugs tend to be highly bound to protein in plasma and highly bound to lipid in peripheral tissues. Most anesthetic drugs are metabolized in the liver.
药代动力学的基本过程分为分配和清除量稀释。这些过程都受药物的物理特性和病人的代谢能力。麻醉药品往往是高度肯定的血浆蛋白和高度的约束外周组织的脂质。大多数麻醉药物在肝脏代谢。