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Finishing YR typesetting Dingdang Maruko Ma Yesterday's content 8:00-9:50 1.
Is there any risk of surgical anesthesia to pregnant women and children Key topics: 1.
Will general anesthesia for pregnant women in early pregnancy affect fetal development? The development of the central nervous system of the fetus starts around five weeks after the last menstrual period.
Before that, general anesthesia will not affect the development of the fetus
.
For pregnant women who usually have irregular menstruation, you can go to the hospital for consultation.
The doctor will assess the risk according to the number of days of pregnancy and the specific type of medication.
In most cases, pregnant women in the first trimester receive a single small amount of anesthesia.
Say it's safe
.
2.
Which diseases are complicated by pregnancy that may face the risk of surgery? Pregnancy complicated by acute appendicitis, acute cholecystitis, pelvic mass and acute ovarian pedicle torsion and other diseases, if not operated in time, will endanger the life of pregnant women
.
For surgery, we must weigh the pros and cons, not just worry about the side effects of the drug, and ignore the life-threatening disease itself to the pregnant woman and the baby
.
3.
Does anesthesia have any effect on the fetus? The peak period of fetal central nervous system development is from the third trimester to within six months after birth, which is also a sensitive period for drugs.
Whether receiving anesthetic drugs at this stage will affect the fetus is currently a research hotspot in the field of anesthesia
.
The mainstream opinion suggests that elective surgery in the second and third trimesters of pregnancy and infants and young children should be postponed as much as possible
.
The following is the 2017 US FDA "Drug Safety Bulletin"
.
In 2019, The Lancet released a prospective study initiated by the United States and participated in 28 countries, showing that infants and young children who received anesthetic drugs and infants and young children who did not receive anesthesia drugs during the same period grew to 2 years old and 5 years old, respectively.
, memory, and intelligence
.
10:20-12:00 2.
How to rescue pregnant women in critical situations Key topics: 1.
What situations do women encounter requiring immediate surgery? Emergency room, ward, and delivery room may all encounter this kind of situation.
Three common symptoms of pregnant and lying-in women in emergency department: abdominal pain, vaginal bleeding, and decreased fetal movement, all of which need to start the green channel immediately to check whether there is any problem with pregnant women and fetuses; In the delivery room, once pregnant and lying-in women enter the labor process, they need to pay attention to the situation of the mother and child at any time
.
2.
Talking about amniotic fluid embolism Amniotic fluid embolism is the most dangerous and irreversible situation encountered by the medical team.
It can lead to coagulation dysfunction, embolism, hypoxemia, etc.
in pregnant women, which mostly occurs during cesarean section.
, during childbirth, and seriously endanger the life of pregnant women, requiring multidisciplinary joint rescue
.
13:00-14:50 3.
Difficulties and Risks of Anesthesia in Minimally Invasive and Interventional Surgery for Children Key Topics: 1.
Differences between Minimally Invasive Surgery and Intervention Minimally invasive surgery and intervention are not the same concept.
The minimally invasive surgeries that doctors refer to are usually thoracoscopy, laparoscopy, arthroscopy, ventriculoscopy and other surgeries
.
Interventions are usually treatments that operate within a blood vessel through a puncture technique
.
2.
What diseases do children often receive interventional therapy for? Mainly hemangioma and vascular malformation, as shown below: 3.
What challenges does minimally invasive interventional surgery pose to anesthesiologists? (1) CO2 gas will oppress the thoracic and abdominal organs, which will affect the respiratory and circulatory systems; (2) CO2 gas will be absorbed into the blood, resulting in changes in the internal environment of the blood; (3) One-lung ventilation is required for neonatal thoracoscopic surgery , which poses great challenges to anesthesia technology and anesthesia management; (4) individual interventional operations will lead to airway edema, which increases the difficulty of anesthesia; (5) due to the development of minimally invasive surgical techniques, general anesthesia needs to be selected for anesthesia.
It is more difficult to regulate airway management, cardiopulmonary function and important organ function
.
4.
What are the challenges of anesthesia in obese children? (1) Airway management: lead to difficult airway and intubation
.
(2) In obese patients, drug metabolism is different from that of patients with normal body type.
Obese children have more fat, and are prone to drug accumulation and delayed awakening
.
(3) Obese children can also cause various puncture and intraoperative hemostasis difficulties
.
15:20—17:00 4.
The key topics of child surgical anesthesia that parents are anxious and must know: 1.
What are the contents of the preoperative visit to pediatric anesthesia? The preoperative visit includes: understanding the child’s condition, whether the child has underlying diseases, the surgeon’s surgical plan and requirements for anesthesia, considering the anesthesia measures you can take, communicating with family members about the risks of surgical anesthesia, and communicating with patients.
Establish close relationship and trust with children, and communicate with family members about the emotional problems of parents when children enter the operating room: If parents are more calm and have a good attitude, children can be infected, thereby reducing tension and anxiety
.
2.
What are the options for pediatric anesthesia? The choice of anesthesia is mainly based on the position, location, duration of surgery, and risks of surgery and anesthesia, such as general anesthesia, local anesthesia, and peripheral nerve block.
These anesthesia methods that can be used by adults are basically the same for children.
can also be used
.
3.
Problems often encountered by anesthesiologists due to improper preparation of children before surgery (1) Loose teeth, family members did not inform, and anesthesiologists did not check
.
(2) The preoperative fasting is not strict (3) The parents conceal the children's upper respiratory tract infection countermeasures: The anesthesiologist should make adequate preoperative visits, assessments and physical examinations, and must observe carefully
.
4.
Problems with the use of postoperative analgesia pumps in children Children’s medication types are limited, and the medication is relatively simple.
They are basically opioids.
The side effects of opioids should be considered during the medication process, such as: nausea, vomiting, itching, urine storage wait
.
Older children can use self-controlled analgesia pumps, and children can use continuous analgesia
.
Is there any risk of surgical anesthesia to pregnant women and children Key topics: 1.
Will general anesthesia for pregnant women in early pregnancy affect fetal development? The development of the central nervous system of the fetus starts around five weeks after the last menstrual period.
Before that, general anesthesia will not affect the development of the fetus
.
For pregnant women who usually have irregular menstruation, you can go to the hospital for consultation.
The doctor will assess the risk according to the number of days of pregnancy and the specific type of medication.
In most cases, pregnant women in the first trimester receive a single small amount of anesthesia.
Say it's safe
.
2.
Which diseases are complicated by pregnancy that may face the risk of surgery? Pregnancy complicated by acute appendicitis, acute cholecystitis, pelvic mass and acute ovarian pedicle torsion and other diseases, if not operated in time, will endanger the life of pregnant women
.
For surgery, we must weigh the pros and cons, not just worry about the side effects of the drug, and ignore the life-threatening disease itself to the pregnant woman and the baby
.
3.
Does anesthesia have any effect on the fetus? The peak period of fetal central nervous system development is from the third trimester to within six months after birth, which is also a sensitive period for drugs.
Whether receiving anesthetic drugs at this stage will affect the fetus is currently a research hotspot in the field of anesthesia
.
The mainstream opinion suggests that elective surgery in the second and third trimesters of pregnancy and infants and young children should be postponed as much as possible
.
The following is the 2017 US FDA "Drug Safety Bulletin"
.
In 2019, The Lancet released a prospective study initiated by the United States and participated in 28 countries, showing that infants and young children who received anesthetic drugs and infants and young children who did not receive anesthesia drugs during the same period grew to 2 years old and 5 years old, respectively.
, memory, and intelligence
.
10:20-12:00 2.
How to rescue pregnant women in critical situations Key topics: 1.
What situations do women encounter requiring immediate surgery? Emergency room, ward, and delivery room may all encounter this kind of situation.
Three common symptoms of pregnant and lying-in women in emergency department: abdominal pain, vaginal bleeding, and decreased fetal movement, all of which need to start the green channel immediately to check whether there is any problem with pregnant women and fetuses; In the delivery room, once pregnant and lying-in women enter the labor process, they need to pay attention to the situation of the mother and child at any time
.
2.
Talking about amniotic fluid embolism Amniotic fluid embolism is the most dangerous and irreversible situation encountered by the medical team.
It can lead to coagulation dysfunction, embolism, hypoxemia, etc.
in pregnant women, which mostly occurs during cesarean section.
, during childbirth, and seriously endanger the life of pregnant women, requiring multidisciplinary joint rescue
.
13:00-14:50 3.
Difficulties and Risks of Anesthesia in Minimally Invasive and Interventional Surgery for Children Key Topics: 1.
Differences between Minimally Invasive Surgery and Intervention Minimally invasive surgery and intervention are not the same concept.
The minimally invasive surgeries that doctors refer to are usually thoracoscopy, laparoscopy, arthroscopy, ventriculoscopy and other surgeries
.
Interventions are usually treatments that operate within a blood vessel through a puncture technique
.
2.
What diseases do children often receive interventional therapy for? Mainly hemangioma and vascular malformation, as shown below: 3.
What challenges does minimally invasive interventional surgery pose to anesthesiologists? (1) CO2 gas will oppress the thoracic and abdominal organs, which will affect the respiratory and circulatory systems; (2) CO2 gas will be absorbed into the blood, resulting in changes in the internal environment of the blood; (3) One-lung ventilation is required for neonatal thoracoscopic surgery , which poses great challenges to anesthesia technology and anesthesia management; (4) individual interventional operations will lead to airway edema, which increases the difficulty of anesthesia; (5) due to the development of minimally invasive surgical techniques, general anesthesia needs to be selected for anesthesia.
It is more difficult to regulate airway management, cardiopulmonary function and important organ function
.
4.
What are the challenges of anesthesia in obese children? (1) Airway management: lead to difficult airway and intubation
.
(2) In obese patients, drug metabolism is different from that of patients with normal body type.
Obese children have more fat, and are prone to drug accumulation and delayed awakening
.
(3) Obese children can also cause various puncture and intraoperative hemostasis difficulties
.
15:20—17:00 4.
The key topics of child surgical anesthesia that parents are anxious and must know: 1.
What are the contents of the preoperative visit to pediatric anesthesia? The preoperative visit includes: understanding the child’s condition, whether the child has underlying diseases, the surgeon’s surgical plan and requirements for anesthesia, considering the anesthesia measures you can take, communicating with family members about the risks of surgical anesthesia, and communicating with patients.
Establish close relationship and trust with children, and communicate with family members about the emotional problems of parents when children enter the operating room: If parents are more calm and have a good attitude, children can be infected, thereby reducing tension and anxiety
.
2.
What are the options for pediatric anesthesia? The choice of anesthesia is mainly based on the position, location, duration of surgery, and risks of surgery and anesthesia, such as general anesthesia, local anesthesia, and peripheral nerve block.
These anesthesia methods that can be used by adults are basically the same for children.
can also be used
.
3.
Problems often encountered by anesthesiologists due to improper preparation of children before surgery (1) Loose teeth, family members did not inform, and anesthesiologists did not check
.
(2) The preoperative fasting is not strict (3) The parents conceal the children's upper respiratory tract infection countermeasures: The anesthesiologist should make adequate preoperative visits, assessments and physical examinations, and must observe carefully
.
4.
Problems with the use of postoperative analgesia pumps in children Children’s medication types are limited, and the medication is relatively simple.
They are basically opioids.
The side effects of opioids should be considered during the medication process, such as: nausea, vomiting, itching, urine storage wait
.
Older children can use self-controlled analgesia pumps, and children can use continuous analgesia
.
