頭面部的神經(jīng)阻滯課件

頭面部的神經(jīng)阻滯服從真理，就能征服一切事物頭面部疼痛的神經(jīng)阻滯中日友好醫(yī)院疼痛科水源神經(jīng)阻滯:在木梢的腦育疃神經(jīng)節(jié)腦脊髖神物或以物予刺激,阻斷神局麻麻醉藥掌月厚→可逆的高濃度化學(xué)性神經(jīng)阻滯神經(jīng)破壞藥等似·非可逆的電物理性如壓穿剌壓法冷卻。冷凍阻滯圖3-1廣義上的神還阻滯作用機(jī)制減少神經(jīng)細(xì)胞膜的鈉離子內(nèi)流降低動(dòng)作電位幅度抑制動(dòng)作電位抑制神經(jīng)沖動(dòng)的產(chǎn)生DurationofactionDependantuponproteinbindingandbloodsupplyOnsetofActionDurationofMaximumActionforAllowableAgent.:.ConcentrationInfiltrationBlockLidocaine1%,2%Immediate4-10Min30-120Min4.5mg/kgof1%(Xylocaine)LidocaineImmediate4-10Min60-240Min.7mg/kgoif-ageadult650mlperaverageadult)Imediate6-10Min90-180Min5mg/kgof1%(Carbocaine(40mlperaverageadult)05Slower8-12Min240-480Min3mg/kgof.25%(70mlperaverageadultSensorcaineSeetext5-15Min20-30Min2-5mlofmixture物理性神經(jīng)阻滯:加熱到80℃進(jìn)行神經(jīng)阻滯的電卻到80℃的冷凍傷方法進(jìn)行的神經(jīng)阻滯,它是對(duì)面肌痙攣用面神刺壓迫來進(jìn)行治療的方法“封閉”與“神經(jīng)阻滯”。兩個(gè)不同的方法和概封閉濃度局麻藥在臟器周止強(qiáng)烈的刺激向中樞傳導(dǎo),促進(jìn)中樞神經(jīng)的負(fù)誘導(dǎo)和保護(hù)性抑制,例如,腎囊封是用闌尾切除術(shù)、腹股溝疝術(shù)時(shí)強(qiáng)烈的反射向中樞傳導(dǎo)。神經(jīng)阻滯的分類從疼痛診療的角度,根據(jù)神經(jīng)阻滯的目的:①為手術(shù)、檢査的目的進(jìn)行神經(jīng)阻滯,此時(shí)可稱為麻醉②為治療疼痛病癥而進(jìn)行神經(jīng)阻滯時(shí),稱為治療性神經(jīng)阻滯③為診斷或鑒別診斷的目的而進(jìn)行神經(jīng)阻滯時(shí),稱為診斷性神經(jīng)阻滯④為判定疼痛病癥的預(yù)后的目的而進(jìn)行神經(jīng)阻滯時(shí),稱為預(yù)后判定性神經(jīng)阻滯神經(jīng)阻滯(解剖部位)分類①脊神經(jīng)阻滯:肋間神經(jīng)阻滯、胸及腰部椎旁神經(jīng)阻滯、臂叢阻滯、枕神經(jīng)阻滯、頸叢阻滯、其他末梢神經(jīng)阻滯②交感神經(jīng)阻滯:腹腔神經(jīng)叢阻滯、胸及腰部交感經(jīng)節(jié)阻滯、星狀神經(jīng)節(jié)阻滯。③脊神經(jīng)和交感神經(jīng)同時(shí)阻滯:骶管阻滯、蛛網(wǎng)膜下腔阻滯、硬膜外阻滯(頸部、胸部、腰部)。④腦神經(jīng)阻滯:舌咽神經(jīng)阻滯、面神經(jīng)阻滯、三叉砷經(jīng)阻滯療法的機(jī)制阻斷疼痛的傳導(dǎo)通道°阻斷疼痛的惡性循環(huán)改善血流狀態(tài)抗炎癥作用砷經(jīng)阻滯療法的特點(diǎn)神經(jīng)阻滯療法的治痛效果明顯可靠對(duì)診斷疾病非常有用°局麻藥和神經(jīng)破壞藥均可應(yīng)用除特殊操作外不需特殊儀器設(shè)備操作技巧和療效密切相關(guān)頭面部神經(jīng)阻滯的分類三叉神經(jīng)及其分支阻滯蝶鄂神經(jīng)節(jié)阻滯面神經(jīng)阻滯舌咽神經(jīng)阻滯枕神經(jīng)阻滯星狀神經(jīng)節(jié)阻滯謝謝46、我們?nèi)粢呀邮茏顗牡?，就再?zèng)]有什么損失。——卡耐基

47、書到用時(shí)方恨少、事非經(jīng)過不知難?！懹?/p>

48、書籍把我們引入最美好的社會(huì)，使我們認(rèn)識(shí)各個(gè)時(shí)代