有奖中英文一句话互译活动

gongtw

以前许多有关MAC的研究都认为吸入麻醉药抑制体动反应的作用是在中枢的脑皮质，但近来一些研究认为其作用是在大脑皮层和皮质下（脊髓）水平。
Numerous previous studies have found that inhaled anesthetics inhibits about MAC is at the hub of the dynamic response of the cerebral cortex, but some recent studies suggest that it is in the cerebral cortex and subcortical (spinal) level.
出自：现代麻醉学  第19章 吸入全身麻醉药

天天潜水1987

A 4 years old child who is involved in a household fire from a faulty air-conditioner with minor explosion is scheduled for emergency surgery. He sustains a penetrating injury to his right eye and an open fracture of his right forearm. On examination, he is alert, crying incessantly and obviously in pain. His vital signs include heart rate 160/minutes, respiratory rate 36/minutes, blood pressure 110/54 and SpO2 98%. He has no significant past history and has his meal 3 hours ago.

1) What are the priorities in the initial evaluation and management of this child? What further information would you need prior to taking him to theatre?

2) How would you determine if he has sustained an inhalational injury? Describe your management of inhalational injury in this patient.

3) Thirty minutes into operation, pulse oximeter alarms “pulse search”, blood pressure monitor reads “error” and electrocardiogram depicts sinus tachycardia. You cannot feel any pulse. What are your differential diagnoses and how would you manage this situation?

Hong Kong Board exam question 2009 March

天天潜水1987

A 4 years old child who is involved in a household fire from a faulty air-conditioner with minor explosion is scheduled for emergency surgery. He sustains a penetrating injury to his right eye and an open fracture of his right forearm. On examination, he is alert, crying incessantly and obviously in pain. His vital signs include heart rate 160/minutes, respiratory rate 36/minutes, blood pressure 110/54 and SpO2 98%. He has no significant past history and has his meal 3 hours ago.

1) What are the priorities in the initial evaluation and management of this child? What further information would you need prior to taking him to theatre?

2) How would you determine if he has sustained an inhalational injury? Describe your management of inhalational injury in this patient.

3) Thirty minutes into operation, pulse oximeter alarms “pulse search”, blood pressure monitor reads “error” and electrocardiogram depicts sinus tachycardia. You cannot feel any pulse. What are your differential diagnoses and how would you manage this situation?

Hong Kong Board exam question 2009 March

linco500

Expert airway management is an essential skill for an anesthesiologist. This chapter reviews the anatomy of the upper respiratory tract, describes the necessary equipment, presents techniques, and discusses complications of laryngoscopy, intubation, and extubation. Patient safety depends on a thorough understanding of each of these topics.
熟练的呼吸道管理是一个麻醉医师基本技能。本章将回顾上呼吸道解剖，描述必需的设备，介绍技术，并讨论喉镜窥视、气管插管和拔管的并发症。患者安全取决于对每一个主题的透彻的理解。

东篱

2010年美国心脏协会心肺复苏及心血管急救指南
Highlights of the 2010 American Heart Association Guidelines for CPR and ECC

ml5448166

与分次肌肉注射镇痛药比较，老年人普胸术后ＰＣＥＡ及ＰＣＩＡ镇痛效果较好，术后早期ＰＯＤ及心肺并发症发生率低。

cpmpared to intramuscular analgesia,postoperative patient-controlled epidural or intravenous analgesia is better in providing analgesia and reducing the incidence rates of POD and postoperative cardiopulmonary complications in thoracic elderly patients.

出处：江苏医药２０１１年１１月第３７卷第２１期　Ｊｉａｎｇｓｕ　Ｍｅｄ　Ｊ，Ｎｏｖｅｍｂｅｒ　２０１１，Ｖｏｌ　３７，Ｎｏ．２１

dalei12345

吸气压力增加
Suction pressure to increase

泽陶

回复 1# shenxiu2


    控制性降压：（controlled hypotension）指在全麻手术下期间，在保证重要脏器氧供情况下，采用降压药物与技术等方法，人为的将平均动脉血压（MAP）减低至50~65mmHg使手术野出血量随血压降低而减少，不至有重要器官的缺血缺氧性损害，终止降压后血压可以迅速回复至正常水平，不产生永久性器官损害。
controlled hypotension：In general anesthesia during operation of important organs, in ensuring oxygen supply conditions, using of antihypertensive drugs and technology, human will mean arterial blood pressure ( MAP ) decreased to 50~65mmHg to ensure that the operation amount of bleeding with blood pressure is reduced, not to have the important organ ischemia hypoxia injury, after reducing blood pressure can be terminated rapid return to a normal level, does not have a permanent organ damage.

2046vip

what is the reason of  the headache after spinal anesthesia ?
腰麻后头痛的原因是什么？
Morgan Clinical Anesthesiology No. 496 摩根临床麻醉学

2046vip

Chapter 25 Rare and Coexisting Diseases
Stephen F. Dierdorf  J. Scott Walton
Key Points
The cytoskeleton of the muscle membrane in patients with muscular dystrophy is abnormal and is susceptible to damage from succinylcholine. Massive release of intracellular contents, including potassium, may occur.
Myotonic dystrophy produces cardiac conduction delay that can manifest as high-grade atrioventricular block.
Patients with myasthenia gravis are exquisitely sensitive to nondepolarizing muscle relaxants. Short-acting muscle relaxants and objective monitoring of neuromuscular function are indicated.
Many types of cancer, in addition to small cell lung carcinoma, can produce myasthenic syndrome.
Patients with multiple sclerosis should be advised that an exacerbation of their neurologic symptoms may occur during the perioperative period.
Repeated episodes of sickling in patients with sickle cell disease cause pulmonary hypertension. Pulmonary hypertension in sickle cell patients is associated with increased mortality.
Rheumatoid arthritis is a multisystem disease that causes subclinical cardiac and pulmonary dysfunction.
Many patients with rheumatoid arthritis have significant degeneration of the cervical spine with few neurologic symptoms. Cervical manipulation during laryngoscopy and intubation requires special precautions.
Esophageal dysfunction in patients with scleroderma or dermatomyositis increases the risk of aspiration pneumonitis.
Patients with epidermolysis bullosa can have undiagnosed dilated cardiomyopathy.
第25章  罕见疾病及合并疾病患者的麻醉

要点
肌营养不良患者肌膜细胞骨架异常，易受琥珀胆碱的破坏，琥珀胆碱可导致细胞内容物（包括钾）大量释放出来。
肌强直性营养不良可导致心脏传导延迟，表现为高度房室传导阻滞。
重症肌无力患者对非去极化肌松药相当敏感，应使用短效肌松药，并客观监测神经肌肉功能。
除小细胞肺癌外，很多癌症都可引起肌无力综合征。
应告知多发性硬化患者，围手术期神经症状会加重。
镰状细胞病患者反复镰状化会导致肺动脉高压，如果合并肺动脉高压，死亡率会增加。
类风湿关节炎是一个多系统疾病，可造成亚临床心功能不全和肺功能不全。
很多类风湿关节炎患者颈椎有明显变性，但几乎没有神经症状。在颈部进行喉镜操作和气管插管时要特别小心。
硬皮病或皮肌炎患者的食道功能不全会增加吸入性肺炎的风险。
大疱性表皮松解症患者可能有未诊断的扩张性心肌病。

出处：Clinical Anesthesia （6th edition）