Modern anesthesiology is a science that studies clinical anesthesia, life function monitoring, intensive care and treatment, and pain diagnosis and treatment.
From the 1940s to now, it has experienced the development of nearly 100 years, which is the primary stage of anesthesiology. At that time, the main responsibility of anesthesiologists was to master and use these techniques, so anesthesiology had obvious characteristics of medical technology departments. This development stage laid the methodological foundation of modern anesthesiology. Clinical anesthesia methodology still takes local anesthesia (including superficial anesthesia), block anesthesia (including nerve block, nerve plexus block and spinal canal block) and general anesthesia as its three important connotations.
(Clinical anesthesia)
The second stage of the development of anesthesiology was from the early 1930s to the late 1950s.
Features:
Due to the accumulation of theory and foundation in the first stage, anesthesiology initially has its own technical and theoretical characteristics.
Because of the particularity of anesthesia technology and the need to ensure the safety of patients, anesthesia staff, not part-time but full-time, must undergo special training and form a professional anesthesia team.
Anesthesiologists should monitor and deal with all kinds of complications caused by surgical trauma, blood loss and coexisting diseases at the same time. Clinical diagnosis and treatment is an important symbol of the development of anesthesiology from medical technology department to clinical department.
195 1 recycling ROM (RR) was formally established.
From the late 1950s to the present.
The establishment and management of post-anesthesia intensive care unit (PACU) and anesthesia ICU developed by RR has become an important symbol of hospital modernization, which provides a strong guarantee for the safety of major surgery and critically ill patients. The development of pain diagnosis and treatment has opened up a new way for anesthesiology theory and technology to serve patients with pain. Therefore, clinical anesthesia, intensive care and pain diagnosis and treatment have become three important branches of anesthesiology, and the adjustment of perioperative life function is the essence of anesthesiology. In addition, emergency center, drug dependence and withdrawal, respiratory therapy and other fields are increasingly dependent on the participation of anesthesiologists and are becoming an important part of anesthesiology.
China's Ministry of Education and Ministry of Health respectively classified anesthesiology as a medical category of clinical medicine (first-class discipline), and made it clear that the two disciplines juxtaposed with internal medicine, surgery and obstetrics and gynecology were the first-class clinical diagnosis and treatment departments of hospitals.
Anesthesiology belongs to two important disciplines in clinical medicine. Anesthesiology is an important first-class diagnosis and treatment department in the hospital, and the director of anesthesiology works under the leadership of the dean. The tasks of anesthesiology department include clinical medical treatment, education and scientific research. Anesthesiology, which conforms to the connotation of the two disciplines, should be composed of outpatient department of anesthesiology, clinical anesthesia (including PACU), ICU, pain diagnosis and treatment laboratory and other departments.
With the progress of hospital management, especially to ensure quality, improve efficiency and reduce patients' burden, anesthesiology outpatient service or pre-anesthesia evaluation center will increasingly become an important part of hospital outpatient service.
Examination, evaluation and preparation before anesthesia
In order to shorten the hospitalization time of patients and ensure adequate preparation before anesthesia, on the basis of preoperative examination and preparation by surgeons, all patients who plan to undergo surgery should be further examined and prepared by anesthesiologists in the outpatient department of anesthesiology as required before admission. Its advantages are:
Patients can arrange surgery after admission, even on the same day, which can significantly shorten the hospitalization date and improve the bed turnover rate.
It can avoid the delay of operation due to incomplete examination before anesthesia.
To prevent conflicts between surgeons and anesthesiologists due to inconsistent preoperative preparation.
Before the patient was admitted to the hospital, the anesthesiology department had been able to understand the condition and the difficulty of anesthesia management, which was convenient for proper arrangement of anesthesia work. At present, the examination, evaluation and preparation before anesthesia are all carried out in the ward. With the acceleration of hospital modernization, hospitals with conditions should gradually transfer this work to outpatient departments.
Follow-up, diagnosis and treatment of anesthesia complications
It is very necessary for anesthesiologists to diagnose and treat postoperative complications. At present, anesthesiologists are not responsible for the diagnosis and treatment of anesthesia complications, especially after patients are discharged from hospital, anesthesiologists have no chance to treat these patients, and the curative effect is not satisfactory. With the establishment of anesthesiology clinic, this situation will be changed, which is beneficial to patients.
Consultation and consultation before anesthesia.
Respiratory therapy, drug dependence withdrawal therapy, etc.
Pain diagnosis and treatment can set up a separate pain clinic or multidisciplinary pain diagnosis and treatment center, and establish the corresponding ward.