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Anesthesialogy - History

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    1

    ,

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    http://www.radikal.ru/
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    , , . , ;

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    XI XIII . ,,,,,.

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    . .

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    , , ,.

    4

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    (1580-1639), , 15 ;

    (1766-1842), -29 .

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    .

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    1516-1590

    .

    . ,. , . , ., 1537 , , . ,. ,,

    , , , . ,.

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    11

    . . ,

    1720 .

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    12

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    13

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    . . L. . Velpeau, 1795-1867

    . ,

    .

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    15

    6 , 6

    1812, ..

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    .

    , , , .

    ,

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    (1734-1815)

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    (N2O)

    1772 .

    Joseph Priestley(1733-1804)

    , (1800). "

    Humphry Davy(1778-1829)

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    Colton, Gardner Quincy, 1814-1898

    ;

    1863 . , ;

    1867 . 20000 ;

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    , , , () , 10 1844 .

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    7 . 25 10 .

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    .

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    ,

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    .. .

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    ,.

    .

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    Mrs. S. . 12 . 150 (). 20 150. 10 100 .

    200 5 . - 500

    45 . , .. ,.,. ..

    (. )

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    Horace Wells (1815-1848)

    , , , 1844

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    Charles Jackson (1805 - 1880)

    William Morton(1819 - 1868)

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    W. Morton

    http://www.asahq.org/wlm/VirtualTour/images/c011aHiRes.jpg
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    16

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    . . .

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    John Collins Warren, 1778-1856

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    ,

    .

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    7 1846 . George Hayward

    .

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    . . , , , ,.

    Mount Auburn Cemetery.

    , 1868, .

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    19 1847 .

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    19 1847 . .21 1847 . , , . .

    . , ( ), ,

    .

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    ,1853

    1853

    1857.

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    .. ..

    -

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    .. (1802 - 1868 )

    7 1847 .. ,

    ;

    . .

    , " ... ".

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    .. (1810 - 1881)

    .. 14 1847 .

    1847 ;

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    ;

    10 000

    .

    .. (1881)

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    45

    1847

    100

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    46

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    .. , 1847 .

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    .. (1810 - 1881)

    " ,

    ". (1847 ).

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    . , 1946 .

    .

    . . ,, . . .

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    ..

    (1847)

    , , ,

    . .

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    (1853-1910 )

    1880 -

    ;

    1880-1881 . . , , ,

    .

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    (1853-1910 )

    in vitro, . ,, .

    , , 20% .

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    (1855-1908)

    ,

    ., 1890;

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    , ,

    , ,

    , ,

    , - ,

    . .. , 4 1896

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    (1811 -1892 )

    1847-1848 ..

    ;

    .. ;

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    18521927

    ,. ypc-,. .

    (1879 ).

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    1886 .

    . - " " -

    .. .

    , .

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    (18651924) .

    1902 .

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    .. .

    .. .

    -, . .

    1904

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    1904. .... .

    .

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    ( 1891- 1954)

    .

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    . ,

    18981976

    ?

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    ?

    http://artclassic.edu.ru/attach.asp?a_no=15043
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    W.F. Kuhne (1864) ;

    Hermann (1866);

    J. Traube (1904, 1913);

    S. Loewe (1912 );

    L.. Pauling(1961);

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    2

    1

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    :

    ;

    ,

    ;

    2

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    :

    , ,. ;

    ;

    ;

    3

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    :

    ;

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    :

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    ;

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    -

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    , .

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    ?

    ,

    1940 - 1/1000 1970 - 1/10 000

    1995 - 1/250 000

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    (Saklad, 1940)

    SA1 (I) ;

    2 (II) ,

    ;

    3 (III) , ;

    4 (IV) , ;5 (V) ,

    24 ;: (Emergent), 1 2 6, 35 7

    ASA

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    ASA

    1 - 0,05%

    2 - 0,4%3 - 4,5%

    4 - 25 %5 - 50%

    (1989)

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    _____________________________________________________________

    1. : 0,5

    1

    2 4

    6

    2. : 0,5

    1

    1,5- , 2

    2,5

    1

    3. : 0,5

    1 + + 2

    + . (, ) 2,5

    :

    I () - 1,5 ; II () - 23 ;

    III () - 3,55 ; IV () - 5,58 ;

    V ( )- 8,512 ;

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    -- 100% 3

    85%.

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    ;

    , 1 : 10000 ;

    linical Anaesthesia, third Edition, 2008

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    3-5

    1

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    III IV < 7 80%

    2

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    , 3

    3

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    > 6

    4

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    5

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    . ,;

    ;

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    ; ;

    ; ; ; ;

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    ;

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    20

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    ;

    ;

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    McGrath

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    Combitube

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    Combitube

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    ;; ;;

    1

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    (. pre - , , medicatio -

    ) - .

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    -

    .

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    :

    ()--- , (), ().

    ;

    ---

    --- ( , .)

    --- 2

    --- 40 3-4

    ;

    ;

    EMLA

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    EMLA-

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    3-5

    ;

    ;

    16-18 , 4-6 ;

    / 10 ;

    :

    ---- , 2 / 10 ;

    ---- 40 /: 0,1% - 0,01 /;

    30

    10

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    http://img0.liveinternet.ru/images/attach/c/1/49/932/49932932_0a2c5_full.jpg
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    --- ---

    ;

    ;

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    3.1

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    +

    +

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    +

    ( )

    /

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    M.L.Mashford, 2002

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    ----

    (

    )

    :--- --- ---

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    (, ) , , , .

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    . , 5 () ,

    .

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    :

    , , ;

    :

    --- ;---

    ;

    :

    --- ;--- ;

    ---

    ;

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    :

  • 7/30/2019 Anesthesialogy - History

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    ;

    ; ; ;

    , ;

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    ;

    ;

    ;

    ; ;

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    - .

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    1 2

    3 4

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    L3/4/5

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    :

    Lignocaine ()

    Bupivicaine ()

    Levo-bupivicaine

    Ropivicaine ()

    / :

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    .

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    Quinke

    ( )

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    ( pencil-point)

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    - 33%;

    - 18 %; - 13%; - 7%; - 2 %;

    - 1%;

    -

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    :

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    ;

    ; ;

    ;

    popliteal fossa. ;

    ;

    ;

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    3.2

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    :

    1. ;

    2. ;

    3. ;

    4. / ;

    , , ,, .

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    Arthur E. Guedel

    1883-1956

    1920 . 4

    I - ;

    II ;

    III - III1 , III2, III3, III4

    IV ;

    Muscle toneResp.s

    s reflexes

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    Stages

    tho

    rax

    diap

    hragm

    p

    Planes

    con

    sciousnes

    eye

    motion

    pupilsize

    eye

    closing

    conjunctiva

    cornea

    vom

    iting

    swallowing

    cou

    ghing

    secretion

    ligh

    t

    sm

    oothm.

    abd

    omen

    lim

    b

    Tolerance

    Excitation

    Analgesia

    Asfixia

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    ;

    ;

    ;

    ;

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    ; ; ; (, );

    ;

    ; ;

    . ;

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    ()

    ----------------------------------------------

    .

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    ()

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    C

    F

    F

    F

    C H

    Br

    Cl

    C

    F

    C

    F

    FO C H

    F

    FClH

    C

    F

    F

    F

    C O C H

    F

    F

    H

    Cl

    C

    F

    FF

    C O

    H

    FC H

    F

    F

    C

    C

    C

    O

    F

    C

    F

    H

    H

    F

    FF

    H

    F

    F

    N N

    O

    CH3CH2 O CH2CH3CHCl 3

    HalothaneEnflurane Isoflurane

    Desflurane

    Sevoflurane

    Nitrous Oxide

    Chloroform Diethyl Ether

    -

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    -

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    70

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    148/163

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    149/163

    /

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    -, , ;

    (, ,, .);

    ;

    ;

    ;

    ();

    ;

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    (1) (100) (1000) (100)

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    (/);

    ;

    ; ; ;

    , BIS-; ; - ;

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    1

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    2

    ,

    .

    .

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    50 5 000 /.

    ASTOTHERM

    http://www.portexland.ru/images/pages/8a9c85ee3ed6d30ba6a193e847547652.jpg
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    158/163

    BIS -

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    BIS -

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    .. . .

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    ?

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    ?

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    THE END


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