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PDPH既往患者への帝王切開 に対する麻酔法の提案
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Yushi Nakaya
June 19, 2017
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PDPH既往患者への帝王切開 に対する麻酔法の提案
東北大学 第1セメスターの授業 「基礎ゼミ - 麻酔科学」にて.
Yushi Nakaya
June 19, 2017
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Transcript
1%1)طԟױऀͷఇԦ։ ʹର͢Δຑਲ๏ͷఏҊ ҩֶ෦ҩֶՊɹ̈ࣃֶ෦ࣃֶՊ ֶ̉෦ిؾใཧֶՊɹ✜ҩֶ෦์ࣹઢֶՊ Ԭ෦ ඈా̈த̉ล✜
2 ൃදͷྲྀΕ Ұൠతͳશຑਲͱہॴຑਲ ྫʹର͢Δຑਲ๏ͷఏҊ ɾױऀͷϓϩϑΝΠϧ ɾ1%1)ͱʁ ɾͦͷଞͷઐ༻ޠʹ͍ͭͯ ɾ۩ମతͳຑਲಋೖ๏ͷఏҊ
3 * Ұൠతͳશຑਲͱہॴຑਲ IUUQTLBOHPPTIJHPUPKQNFEJBBSUJDMFΑΓɺࣸਅΠϝʔδͰ͢ɻ
4 * Ұൠతͳશຑਲͱہॴຑਲશຑਲ ɾಋೖ͕͍ ɾ৴པੑ͕ߴ͍ ɾ࠶ݱੑ͕ߴ͍ ɾௐઅੑ͕ྑ͍ ɾ݂ѹ͕ආ͚ΒΕΔ ར ܽ
ɾମͷޡᅞͷՄೳੑ͕ߴ͍ ɾૠࠔͷස͕ߴ͍ ɾࣇͷༀࡎമ࿐ ɾઙ͍શຑਲதͷ ɹମͷ֮੧ͳͲ͕͋Δɻ
5 ɾखज़͕؆ศͰ͋Δ͜ͱ ɾಋೖ͕͍ ɾ්͕֮੧͍ͯ͠Δ ɾࣇͷༀࡎʹର͢Δമ࿐͕গͳ͍ ɾޡᅞͷةݥ͕গͳ͍ * Ұൠతͳશຑਲͱہॴຑਲہॴຑਲ ͘ບԼຑਲͷར
6 ɾ݂ѹͷස͕ߴ͍ ɾṯ࣌ͷᅅؾ ɾᅅుͷՄೳੑ ɾߗບἥޙͷ಄௧ ɾ࡞༻͕࣌ؒݶΒΕ͍ͯΔ * Ұൠతͳશຑਲͱہॴຑਲہॴຑਲ ͘ບԼຑਲͷܽ
7 ɾମ݂ѹͷසͱఔ͕͍ܰ ɾ಄௧ͷൃੜස͕গͳ͍ ɾ࣌ؒखज़͕Ͱ͖Δ ɾࣇͷༀࡎʹର͢Δമ࿐͕গͳ͍ ɾज़ޙͷਞ௧ཧʹ༻Ͱ͖Δ * Ұൠతͳશຑਲͱہॴຑਲہॴຑਲ ߗບ֎ຑਲͷར
8 ɾٕज़తʹෳࡶ ɾຑਲͷ࡞༻ൃݱ͕͍ ۓٸͷঢ়گͰ༻͍ΒΕͳ͍ ɾଟྔͷہॴຑਲༀΛ༻͍Δඞཁ͕͋Δ * Ұൠతͳશຑਲͱہॴຑਲہॴຑਲ ߗບ֎ຑਲͷܽ
9 ** ྫʹର͢Δຑਲ๏ͷఏҊ ױऀͷϓϩϑΝΠϧ ɾ৷ि ମॏLH DN ɾࠎ൫Ґ ɾલճఇԦ։ͷطԟ ɾลԑલஔ൫
ɾ1%1)ͷطԟ
10 ** ྫʹର͢Δຑਲ๏ͷఏҊ ຑਲͷಋೖʔ༻͢Δༀࡎ ϝτΫϩϓϥϛυNH ϑΝϞνδϯNH ࣄલ༩ɿ ੩ɿνΦϖϯλʔϧNHLH ෆಈɿεΩαϝτχϜNHLH ௧ɿϨϛϑΣϯλχϧЖHLH
11 ېسༀ IUUQWFUDZHOJDPKQEJTQ$4G(PPET1BHF@KTQ (00%4@/0 ϓϩϙϑΥʔϧ
12 ېسༀ IUUQWFUDZHOJDPKQEJTQ$4G(PPET1BHF@KTQ (00%4@/0 ϓϩϙϑΥʔϧ ώτࣇҠߦ͢Δ͜ͱ͕ใࠂ͞Ε͍ͯΔ
13 ** ྫʹର͢Δຑਲ๏ͷఏҊ IUUQFBOFTUIFYCMPHKQQBHFΑΓ
14 ** ྫʹର͢Δຑਲ๏ͷఏҊ ཹҙࣄ߲ ɾ1%1)ͷطԟ ɾࠎ൫Ґ ٯࢠ ɾลԑલஔ൫ ɾલճఇԦ։ʹ͓͚Δൽෘͷ༊ண
15 1%1) ߗບ֎ἥޙ಄௧ ͱʁ 1%1)QPTUEVSBMQVODUVSFIFBEBDIF IUUQXXXTIJLBLVCPTFJLPUTVJODPN[VUTVΑΓ
16 IUUQESHVJEFOFUJHBLV&"""&#"&#%%&&#&ΑΓ ࠎ൫Ґͱʁ
17 ลԑલஔ൫ͱʁ IUUQOBHPZBDPNNVOJUZOFUGVUVSF7PMEJTFBTFIUNMΑΓ
18 IUUQTNFEJDBMOPUFKQDPOUFOUT$4'*,6ΑΓ
19 લճఇԦ։ͷطԟ ൽෘͷ༊ணͷՄೳੑ ग़݂ͷڪΕ
20 ࣇͷຑਲༀͷҠߦΛߟྀʂ ** ྫʹର͢Δຑਲ๏ͷఏҊ
21 ͝ਗ਼ௌ͋Γ͕ͱ͏͍͟͝·ͨ͠ɻ