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179 cases of traumatic brain injury Anesthesia


Atropine, indwelling catheter. Operative position head elevation 1o ~ l5 degrees , but shock patients disabled. ② induction of anesthesia should be smooth to avoid choking when intubation, and hold your breath. Additional time after intubation, anesthesia and respiratory support , surgery to control the light anesthesia state. Section 1 of the suction enflurane anesthesia or isoflurane anesthesia can be deepened in a timely manner , while also lowering intracranial pressure. Sodium hydroxybutyrate has a good sedative and hypnotic effects . And no effect on cerebral blood flow . Lytic cocktail sedation , analgesia and reduce Nie ideal blood flow and cerebral oxygen consumption. Surgery a few times to maintain an additional medication , in particular, / J '. JL , and elderly patients to be more careful surgery to keep the airway clear of blood , secretions . ⑨ traumatic brain injury with intracranial hypertension signs, most of the preoperative and intraoperative time to enter the dehydrating agent according to the condition , often 2O mannitol or sorbitol 25 dose of 1. o ~ 2. og / kg. IV completed in a short time . When necessary, intravenous furosemide ④ cranial Nie more blood loss , but due to increased intracranial pressure caused by high blood pressure often inherent in hemorrhagic shock cover up the signs , such as failure to blood transfusion, surgery to lift once the cause ( such as hematoma evacuation ) decreased intracranial pressure ,[link widoczny dla zalogowanych], shock appears . In particular, 4 ', JL mainly to the input of whole blood , blood transfusion may lose a small amount of intermittent fluid balance l for non- bleeding from the blood pressure drop can be quiet about depression lOOral 5o glucose , no more than 2oon-, J, if no response then l Pressure medicine. Common metaraminol , dopamine and norepinephrine , the dose can be determined according to the disease . 4 Summary The main purpose of Nie trauma is to remove the hematoma and bleeding. Anesthesia endotracheal anesthesia is generally used is appropriate. Conducive to clear respiratory secretions or foreign bodies , and implementation of adequate oxygen hyperventilation, such patients are often very sensitive to anesthetics . Surgery should be controlled in the light anesthesia state. Often accompanied by intracranial hypertension blood pressure was significantly increased. Once opened a skull flap , the blood pressure to drop to undetectable fork extent , therefore, must be prepared for rapid blood transfusion . Anti further cerebral hypoxia . Stable anesthesia and intraoperative blood transfusion right time , transfusion is the prerequisite for success or failure of surgery .