Download - التخدير العام
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) ( 4. ) . ( Pregnancy test ) . ( Serum glucose level 04 . 04 . 5. 6. 7.
:- / . Prothrombine time 1. 2. / Partial thromboplastine time / . bleeding time / . Platelet count 3. 4.
04 5. / . Chest X ray / . Liver function test / Tuberculin test /. Serum Electrolyte / . Lung function test / . Stress ECG 6. 7. 8. 9. 01.
11. / Echo . cardiography
:- 1- ) CBC ) Complete blood count / 41 61 % 21 51 %
991 Hb 9 % 4 11 Mchc mean corpuscular hemoglobin con cerntration 03 04 / 001 ) ( Mchc 07 : Mcv mean corpuscular valume 69 ~ ) ( . :- 72 13 7.1 1.2 . ~ : RBC Red blood cell 4.5 / 3 . 8.4 / 3 . 6 / 3 .
CBC 05 . 2- ~ . Blood urea , creatinine :- 62 / 001 003 / 001 " " 1.1 / 001 / . 3- . : Urine analysis
002 . 4- : 06 . Serum glucose level 001 / 001 . . . . 5- : : Electro Cardiography 04 04 . 6- : : Chest X Ray 04 7_ . : Prothrombin time 21 61 ) ( . 8- : : Bleeding time 1 7 ) ( . 9- -: : Platelet cunt 000.051 000.054 / 3 ) ( . 01- : : Liver function test LFT
102 LFT . ( ) Fibrinogen , Globulin , Albumin " " 5.0 2 mg / dl ( . 11- : : Serum Electrolyte :- )1( ~ 031 051 / : . 001 002 / . )2( ~ 5.3 5.5 / . )3( ~ 8 9 01 / . 5.2 5.7 / . )4( ~ 89 701 / . 001 002 .
:
202 . ) ( . . . . .Heart Failure : Congestive . : Complete Heart block
/ / . .
:- 1-
302 Syncytial Virus Endocarditis .Myocarditis 2- . 3- : - . - ) ( Dyspnea . - . - . 4- :- . . . ) (
402 Angiocardiogram Angiocardiography . Congestive Heart failure ) ( :-
1.
. . Digoxine Ischemic heart disease
2.
:-
.
502 03% 5 % 2.1% ) (Tarahan . ( ( Invasive monitoring 04% . 2002 . 4-
602
:- 011 42 . .
. . ) 011/ ( .
, . :- . . . .
702 . . . .
:- . . .
:-1. . 2. . 3. .
802 1.
. 2. . 3. . 4. . 5. .
:- - ~ .
902- ~ Obstructive ) ( Restrictive ) ( Pulmonary fibosis ) ( Alveolitis fibrosis . Kypho - Scoliasis :- - . - . - . :- Aspirin . Atenolol 3- :- . .
012 . . ( ) . 4- :- . 5- :- Chest Pain .
:- . . . . . . :- : :-
1121- . 2- . 3- . : :- :- . . .
.
:- 1. :- . .
. 2. . 3. :-
212 . Isoprenaline . Salbutamol 4. Bisolvan . :- : :- :- 1. . . 2. 3. . Surfactant 4. . 5. ) ( . . . 6. 7.
8. 52% . . : ) ( :-
312 ) ( Epidural Spinal :- Thiopentone, Tbocurarins Midazolam, Ketamine, Etiomedate, Diprivan Bronchospasm Aminophyline ,Atropine Ipratropium .
:- 01 / 001 . . ) / / ( 3.2 Diphosph Glycerate .
:- ) ( :-
412 . Prothrombine . Manitol . .
:- . ) Low sub ( arachnoid epidnral Gallmine .
:- 003 / :- . 05
512 081 % . 42 .
:- , " " Creatinine . :- : / . / . :- 1- 01 % 005 + 01 + 01 kcl / meg 4 . 2- 01 + 01 + 005 01% . 3- :- .
612 ) ( Sliding Scale . 1 2 / 01 01 005 01% . 05 05 / / 1 2 / . :- 2 4 6 8 01 0/0 051 0/0 051 002 = = 0/0 002 052 = = 0/0 052 003 = = 0/0 003 053 = = 0/0 004 054 = =
.
1- .
7122- . 3- . 4- . 5- . 6- . 7- . 8- . 9- . :- :- - . - . - . . 01- . 11- .
812
:- . 1. 2. . . 3. 4. . . 5.
:- 1- ) (Alfa Amino Butyric Acid . :- - / 01 02 5 __ 01 , 4 8 . - / 51 07 001 / 03 06 .
2- Phenothiazine
912- Promethazine ~ . - ~ Trimeprazine Tartarate 2 4 / .
3- Anticholinergic Agents :-* Atropine :- 1. 3 . . . . 2. 3. 4.
6.0 50.0 / . * ~ Hyocine Hydrobromide . 01 03 . * ~ Glycopyrolate . 2.0 4.0 ) 4 8 / (.
4 _ .
5- Anti free Redicals .
022 1. . 2. . 3. 6 . 4. . 5. ) ( . 6. . 7. . 8. . 9. .
122
222 , . . .
1- . 2- . 3- . 4- . 5- . 6- . 7-
322 . 8- . 9- . 01- .
:- 1- . 2- . 3- . 4- . 5- . 6- . 7- . 8- )) (( . 9- .
:- 1- . .
422 . 2- . 3- . 4- . 5- . 6- . 7- . 8- . 9- . 01- .
, .
522 , . . . . ) ( . ) ( " " . 2 3 04 % 06 001% .
. .
. . .
622 . . . . .
.
:- 1- - . -. 2-: . 3- : , . 4- : . 5- .
" " - - 2 5.2 / . - . - 03 09 . - . :- ) (
722 1- . 2- . 3- . 4- . 5- . 6- . 7- . 8- . 9- . 01- .
822 .
.
922 :- . .
. . . . .
032
132
. . .
232 . . .- .
. . . . . .
.
,
332 , , , . , .
432 )) - - (( ) ....( )) ((. .
:- 1- . 2- . 3- . 4- .
:-)) ((
532 , . .
: :- .
Total Intraveanous anaesthesia
632Target contorl (( )) inufusion , . :- 5 001 , 2 001 8 001 7 4 - , , .
:-1-
732 . 2- , , , , . 3- . , .
1- :- (( PRPOFOL ))DIPRIVAN
2 :- . 3- :- .
832 . . 1- 2-
3- 4-5- 6- 7- 8-
. . . . .
.
.
" - ) ( -
932 1% ) 1 1% ( . - + + . :- 1(
: 52 05 .
: 5 / 52 . 52 04 / = 8 / . 53 / = 7 / . 4 ~ 52 / = 5 / . :- 2(
: 8.0 2.1 / ) 1 2 ( . :- 57.0 5.1 / . 5.0 1 / . 3.0 5.0 / . :- 01 :- :-
" " 5 .
042 :- 1- .
2- 3-
.
. 4- . 5- .
6-
. 1-4 . .
7-
142 :- . :- . :- . :- . :- . :-
242 . :- , . . . , . : )) :-(( / / // . :- - . - . - . - . -.
342 :- - . - . - . - . - . , , .
442
. .
542 :-
1- 2- 3-
.
.
1 5.2 .
4-
.
5-
.
:- 1- 51 . 2- . 3- .
6424- .
1- simus position , . : - . - . - . -
742
2- : 54 , 42
1-: : 1 1.0 ) ( 01 :- .
842- . - . - . - . - . : - . - . - . : . .2- : 800.0 / 50.0 / 01 1 5.0 / 52.0
942/. : * 440.0 / 5-01 . . * .
1- 001% 5.2 1 ) ( . 2- : -
052. - . . 3- 42 . 4- )( . 01 .
251
252
: 1-:- 001 02 04 . . 2- :- . . .
:- 1. . 2- . 3- - :- 1- .
3522- . 3- . 4- . 5 - . 6- . 7- . 8- . 9- . 01- . - :- 1- . 2- . 3- . 4- . 5- . 6- . 7- . 8- . 9- . - 1- . 2- . * :- - - - B.P -
452
* :- 1- . 2- . 3- ) 5%- N.S . 4- 5- 6- 7- 8- 9- 01- 52% 11- 21- 31- :- , :- 1- . 2- . 3- . 4- .
552 2O 4-6 . 5- . 4 . 02 . :- 1- . 2- . 3- . 4- . :- 1- . 2-
652 . * :- 1- . 2- . 3- )( 4- . 5- ) ( 6- . 7- . 8- .
:- 1- . 2- . 3- .
7524- . . 5- . 6- . 7- .
1- -
852 ) (. :- . .
2( 02 . .
2- :-
1-
. 2- .
3- 4-
.
) (.
9525- .
6-
.
7-
. :- 1- 6 %. 2- . 3- . 4- . 5- . 6- . 7- . :-
062 ) ( .
4- :- 1- . . 2-
162 .
5- :-1- . 2- . 3- . 4- . 5- .
:- 1- . 2- . 3- . 4- . 5- . 6- .
6- :-- : :- 1- .
2622- . 3- . 4- . 5- - . - :- 1- . 2- . 3- . 4- . 5- 06 3 . 6- . 7- )) (( 8- . :- 1- . 2- . 3- . 4- .
3625- 2O . 6- . 7- . 8- . 9- .
* - :- 1- . 2- . 3- .
- )( :- :- 1- . 2- . 3- )(
462:- 1- . 2- . 3- .
- . :- 1- 2- 3- . 4- . 5- . 6- . :- 1- . 2- . 3- . 4- .
- :-
562 . :- 1- . 2- . 3- . 4- . 4- .
* . :- 1- . 2- . 3- . :- 1- . 2- .
6623. . 4. . 5. .
* :- 1- ) - - ( . 2- . 3- . :- 1- . 2- . 3- . 4- . :- .
* :-
7621- . 2- . 3- . 4- . 5- . 6- . 7- . 8- . 9- . :- 1- 2- 3- . 4- . :- 1- . 2- .
* :- 1- . 2- . 3- . 4- . :- . 1-
862 . . . 5.83 . . 2-
3-4-
:-
1-
- ) ( . - . - . - 2- :- . 3- :- . 4- :-
962
.5- : - :- . - :- 1- . 2- . - :- . - :- . - . 7- :- 4 :- 1- .
0722- . :- :- 1- : . 2- . 3- 01 . 4- 01 . 5- . 6- . 7- . 8- . 9- . 01-:- .
*
172 .
:- . 1-
2-
.
272
273
472
275