回复:help! toddler needs surgery

来源: 2009-01-12 13:25:37 [] [博客] [旧帖] [给我悄悄话] 本文已被阅读: 次 (2493 bytes)
Among the most widely used injection anaesthetics are:

1. Propofol
2. Etomidate
3. Barbiturates such as methohexital and thiopentone/thiopental
4. Benzodiazepines such as midazolam and diazepam
5. Ketamine
你可以上网自己查.我今天不上班,进不了医院的link,没法copy一个表给你.
我只查到以下几个:
1.Propofol (Diprivan) is a nonbarbiturate hypnotic agent and the most recently developed intravenous anesthetic. Its rapid induction and short duration of action are identical to thiopental, but recovery occurs more quickly and with much less nausea and vomiting. Also, propofol is rapidly metabolized in the liver and excreted in the urine, so it can be used for long durations of anesthesia, unlike thiopental. Hence, propofol is rapidly replacing thiopental as an intravenous induction agent. It is used for general surgery, cardiac surgery, neurosurgery, and pediatric surgery.

3.Thiopental (Pentothal) is a barbiturate that induces a rapid hypnotic state of short duration. Because thiopental is slowly metabolized by the liver, toxic accumulation can occur; therefore, it should not be continuously infused. Side effects include nausea and vomiting upon awakening.

5.Ketamine (Ketalar) affects the senses, and produces a dissociative anesthesia (catatonia, amnesia, analgesia) in which the patient may appear awake and reactive, but cannot respond to sensory stimuli. These properties make it especially useful for use in developing countries and during warfare medical treatment. Ketamine is frequently used in pediatric patients because anesthesia and analgesia can be achieved with an intramuscular injection. It is also used in high-risk geriatric patients and in shock cases, because it also provides cardiac stimulation.

Recommended dosage:
The dosage depends on the type of anesthetic, the patient's age and physical condition, the type of surgery or medical procedure being done, and other medication the patient takes before, during, or after surgery.

小孩做手术时有专门培训的Pediatric anesthesiologists.一般由手术医师为你选择.你可以要求见麻醉师,问一下用哪一种麻醉药.手术前有任何疑问都要问清.医生会详细询问孩子的用药过敏史.
我的理解是:大医院里的resident做手术时还是有attending physician supervise 的,特别是那个医院是teaching hospital. (An attending physician will supervise fellows, residents/registrars and medical students.)
第三年的resident是否可以单独做手术,我就不知了.一会儿由医生回答你.





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really appreciate your help! -tidytiger- 给 tidytiger 发送悄悄话 tidytiger 的博客首页 tidytiger 的个人群组 (96 bytes) () 01/12/2009 postreply 13:50:46

回复:回复:help! toddler needs surgery -医实注行- 给 医实注行 发送悄悄话 医实注行 的博客首页 医实注行 的个人群组 (220 bytes) () 01/12/2009 postreply 19:32:12

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