1、1,The anesthesia of ectopic pregnancy宮外孕手術(shù)的麻醉,林瑩,2,Ectopic pregnancy is the most common emmergency surgery. The anesthesia depends on the degree of blood loss. 宮外孕手術(shù)為常見的急診手術(shù)，麻醉處理主要取決于失血程度。,3,Before the operation,we should estimate the blood loss and the whole body condition of the patient quickly. A

2、nd prepare for blood transfusion to rescure hemorrhagic shock. 麻醉前要對病人的失血量和全身狀態(tài)做出迅速判斷，并做好大量輸血準(zhǔn)備，以便搶救出血性休克。,4,How to estimate the blood loss?,Early shock blood loss 400-600ml Mild shock blood loss 800-1200ml Moderate shock blood loss 1200-1600ml Severe shock blood loss 2000ml 休克前期 失血量約為400-600ml 輕度休克

3、 失血量約為800-1200ml 中度休克 失血量約為1200-1600ml 重度休克 失血量約為2000ml,5,For early and mild shock ,we can choose small dose epidural anesthesia on the base of sufficient fluid infusion . 休克前期或輕度休克應(yīng)在輸血輸液基礎(chǔ)上，選用小劑量硬膜外阻滯,6,For moderate and severe shock ,we can choose local anesthesia or general anesthesia if it didnt

4、be improved after comprehensive cure. 中度或重度休克，經(jīng)綜合治療無好轉(zhuǎn)者，應(yīng)酌情選用局麻或全麻,7,For severe shock ,we could first stanch the bleeding after local infiltration anesthesia. When the shock is improved ,then use complex anesthesia, for example diazepam and ketamine. 嚴(yán)重休克，可先在局部浸潤麻醉下進(jìn)腹止血，經(jīng)補(bǔ)充血容量待休克好轉(zhuǎn)后再給予地西泮、氯胺酮等復(fù)合麻醉,8

5、,If we choose trachea cannula anesthesia ,wed better use the drug which restrains the cardiovascular system less, for example etomidate、 ketamine 、anectine. 選用氣管內(nèi)全麻，宜選用對心血管抑制較輕的依托咪酯、氯胺酮、琥珀膽堿復(fù)合麻醉,9,When modivating ,prevent anabole and aspiration誘導(dǎo)時(shí)，嚴(yán)防嘔吐誤吸 During the operation ,supply whole blood、dextran and equilibrium liquid according to the blood loss ,then correct metabolic acidosis and maintain renal function麻醉中，根據(jù)失血量補(bǔ)充全血、代血漿和平衡液，并糾正代謝性酸中毒，維護(hù)腎功能 After the operation ,prevent infection