The working field of Anesthesiologists
Clinic anesthesia
– Operating room, PACU, outpatient,
CPCR (cardiopulmonary cerebral resuscitation)
CCM (critical care medicine) Analgesia
Anesthesia machine (1930)
Intravenous anesthetics
1934: thiopental 1959: diazepam 1960: hydroxybutyrates, r-OH 1970: ketamine 1972: etomidate 1976: midazolam 1983: propofol
How about our department of anesthesiology?
～1956：surgeon
1957：anesthesia group 60-70：epidural, spinal, nerve block 70-80：CPB, intravenous anesthesia, and
inhalational anesthesia 80-85: intravenous anesthesia, inhalational
anesthesia, ECG, arterial blood pressure, CVP 80-90：inhalational anesthesia with timing injection
Morton's ether inhaler (1846)
John Snow, the first anesthesiologist （1846）
Machine of Inhalational anesthesia in 1847
Face mask (1847)
History of inhalation
Local anesthetics
1884：Cocaine as ophthalmic anesthesia, nerve block 1885：Epidural anesthesia 1898: Spinal anesthesia 1901：Caudal anesthesia 1905：Procaine 1930：Dibucaine 1932：Dicaine 1943：Lidocaine 1963: bupivacaine 1996: ropivacaine More new: levobupivacaine
Introduction of Clinical Anesthesia
Department of Anesthesiology Cui Xiao Guang
Concept
Using Drugs or other methods Central Nerve System or peripheral
of volatile anesthetics 90-present：depth of anesthesia, balance
anesthesiaPopula源自 anesthesia words
ASA physical status classification system TOF: train of four BIS: bispectral index CVP neurostimulator SG: Swan Ganz catheter MAC: minimum alveolar concentration TEE: transesophageal echocardiography
Stone Age: spicula analgesia Acupuncture Traditional medicine Pressure Cryotherapy And others
History of anesthesiology
1846 public demonstration of ether anesthesia by William T. G. Morton
近代麻醉学发展的三个重要阶段
麻醉：19世纪40年代算起，近100年的发展历程。 临床麻醉学（clinical anesthesiology）：初步形成临
床麻醉学的五大组成。 麻醉与危重病医学（anesthesiology and critical care
medicine）： 从20世纪50年代末至今，一次作用要的飞跃，特别 是近30余年的发展
Others
Opioids
– Morphine, fentanyl, sufentanil, alfentanil, remifentanil
Relaxants
– Curare(1942), succinylcholine, pancuronium, vecuronium, atracurium, rocuronium, mivacurium, at al.
nerve system Losing sense, painless and
comfortable, temporarily
What can you do for your future?
expertise in resuscitation fluid replacement airway management oxygen transport operative stress reduction postoperative pain control ICU
法国、日本等——麻醉复苏科（department of anesthesiology and resuscitation）；
美国等——麻醉与危重病医学科（department of anesthesiology and critical care medicine）。
Archaic anesthesia