[關於反芻動物全身麻醉的風險，反芻動物中，全身麻醉的弊大於利。] 有興趣的朋友可以多了解一下喔! (中文翻譯的部分為Google翻譯的，能夠閱讀英文的朋友建議看原文會比較清楚喔)
還有很多很多相關的學術發表，就不貼那麼多出來啦!

Cooper結紮的日期是4月26日，他現在很健康很調皮。

(德叔真的超級超級愛看這些學術發表的文章，但是我還是相信醫生的專業。)

https://www.researchgate.net/publication/334673867_The_Use_of_Epidural_Anaesthesia_over_General_Anaesthesia_in_Ruminants
全身麻醉是現代醫學的重要組成部分。它是一種藥物誘導的可逆病症，包括特定的行為和生理特徵，包括無意識、健忘症、鎮痛和運動不能——伴隨自主神經、心血管、呼吸和體溫調節系統的穩定性。
[反芻動物全身麻醉具有內在風險，如瘤胃內容物反流、唾液分泌過多和肺部誤吸的可能性；因此並不總是推薦使用本地或區域技術。硬膜外麻醉是一種中樞神經阻滯技術，經常用於獸醫實踐中，用於治療家畜會陰、骶骨、腰椎和尾椎部位的不同產科和外科手術干擾。關於在反芻動物和其他物種的各種外科和實驗室程序中使用硬膜外麻醉的科學研究已經有幾項。總之，全身麻醉的弊大於利，特別是在反芻動物中。因此，硬膜外麻醉是首選。

General anaesthesia is an essential component of modern medicine. It is a drug induced reversible condition that includes specific behavioral and physiological traits unconsciousness, amnesia, analgesia, and akinesia- with concomitant stability of the autonomic, cardiovascular, respiratory, and thermoregulatory systems.
[General anesthesia in ruminants has inherent risks such as regurgitation of ruminal contents, excessive salivation and the possibility of pulmonary aspiration; therefore it is not always recommended and local or regional techniques may be used instead. Epidural anaesthesia is a central neuraxial block technique which is used regularly in veterinary practice for treatment of different obstetrical and surgical interferences in the perineal, sacral, lumbar, and caudal parts of the thoracic region of domestic animals. There have been several scientific researches on the use of epidural anesthesia in ruminants and other species for various surgical and laboratory procedures. In conclusion, the disadvantages of general anaesthesia outweigh the advantages especially in ruminant specie. Therefore, epidural anaesthesia is the most preferred.

https://onlinelibrary.wiley.com/doi/abs/10.1002/9781118886700.ch1
瘤胃鼓脹、腹脹、反流和吸入性肺炎是與家畜全身麻醉相關的常見問題，應通過適當的預防措施和必要的麻醉前考慮來預見和解決。家畜在麻醉期間可能會出現胃內容物反流和誤吸，尤其是未禁食的動物。反芻動物在麻醉期間通常會大量分泌唾液。惡性高熱的觸發因素包括壓力（例如興奮、運輸或麻醉前處理）、鹵化吸入麻醉劑（例如氟烷、異氟烷、七氟烷和地氟烷）和去極化神經肌肉阻滯藥物（例如琥珀膽鹼）。同樣，氟烷似乎是豬惡性高熱的最有效和最常見的觸發因素。麻醉前禁食可能不能完全防止反流，但會減少瘤胃內容物中的固體物質數量。獸醫應將這些知識與適當的麻醉前準備和適當的圍手術期管理相結合，以確保這些動物的麻醉成功。
Ruminal tympany, bloat, regurgitation, and aspiration pneumonia are common problems associated with general anesthesia in farm animal species that should be anticipated and addressed with proper precautions and the necessary preanesthetic considerations. Regurgitation and aspiration of stomach content can occur in farm animal species during anesthesia, especially in nonfasted animals. Ruminants normally salivate profusely during anesthesia. The triggering agents of malignant hyperthermia include stress (e.g., excitement, transportation, or preanesthetic handling), halogenated inhalation anesthetics (e.g., halothane, isoflurane, sevoflurane, and desflurane), and depolarizing neuro-muscular blocking drugs (e.g., succinylcholine). Similarly, halothane appears to be the most potent and most frequently reported trigger of malignant hyperthermia in pigs. Preanesthetic fasting may not completely prevent regurgitation, but it will decrease the amount of solid matter in the rumen content. Veterinarians should incorporate the knowledge with proper preanesthetic preparations and appropriate perioperative management to ensure successful outcome of anesthesia in these animals.

Dialogue with a Theatre Nurse♪

有興趣成為theatre nurse的一定要來看這篇！！(๑>◡<๑)

最近認識了一位在英國的theatre nurse
她很大方的分享了很多有趣又有用的資訊喔！

其他補充資料☆

Surgical Assistant 資料: https://bucks.ac.uk/courses/short-course/surgical-first-assistant-perioperative-practice
Example 職位: https://www.jobs.nhs.uk/xi/vacancy/916272479

ODP入職要求和課程: https://www.healthcareers.nhs.uk/explore-roles/allied-health-professionals/roles-allied-health-professions/operating-department-practitioner/entry-requirements-and-training-operating

她也很友善的提出 如果有任何關於theatre nurse 的問題 我也可以代轉達喔♥︎

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有興趣的也請到Nurse Risu in UK 的instragram🐿
https://www.instagram.com/nurserisuinuk/?hl=zh-tw
編排會更容易看些♪

護士Risu在英國 - Mewe 🐿
https://mewe.com/i/nurserisuinuk
護士Risu在英國 - OET溫習討論小組
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護士Risu在英國－ CBT&OSCE溫習討論小組
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護士Risu在英國 - 英國護士工作及生活分享
Fb: https://www.facebook.com/groups/713461155943610/
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歡迎一齊傾下計🥰

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《ASA麻醉風險分級》怎麼分？
#佳霖醫師麻醉教室

今天想跟大家介紹「ASA麻醉風險分級」
此麻醉風險評估標準是採用
美國麻醉醫師學會(ASA)建議分類等級
一般來說，依照病患的病情和生理狀況
分成【第一級】到【第六級】等六個不同等級

因此，當病人的ASA分級越高
則能預測病人接受手術時的併發症等風險
#perioperative risks 是越高的喔！

提醒大家年終將近聚會很多
大家要繼續做好防疫措施
配戴口罩，保護自己也保護別人！

李佳霖醫師 - 麻醉專科女醫生
#ASA麻醉風險分級
#任何麻醉相關疑問歡迎留言
#佳霖醫師麻醉安全推廣