[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.
同時也有1部Youtube影片,追蹤數超過3萬的網紅With Yumi,也在其Youtube影片中提到,哈喽!好久没分享爱用品了,你们喜欢这种主题吗? 这周末上传煮饭vlog!等我!新加坡这边开始国庆节放假咯~ 爽歪歪~ 妈咪会来我家玩,我也约了朋友,开心!记得来微博or Instagram找我~我们可以聊天❤️ ?//Instagram// Yumi.Koh https://www.instag...
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唔知牛年對大家來說有沒有特別意義?
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醫者有社會責任去保障公眾健康,我們認為梁卓偉教授和陳家亮教授作為香港兩所醫學院院長責無旁貸。因此,我們呼籲所有醫護人員參與連署,懇請兩位院長履行社會使命發表聲明保障社會大眾的健康和人身安全。
連署連結: https://forms.gle/teMGNCiZPMYatVbh8
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《致香港大學李嘉誠醫學院院長、中文大學醫學院院長的公開信》
梁教授、陳教授道鑒:
有鑑於在六月十二日、七月二日及二十一日,香港警察濫用武力以控制群眾。如此行徑實對公眾健康遺害無窮,我們一眾醫療人員對此極為關切。作為香港大學李嘉誠醫學院院長、中文大學醫學院院長,吾等懇請兩位院長細察香港警察控制群眾之手段,以保障公眾健康。
據多家本地及國際媒體報導,香港警察於六月十二日,發射多輪催淚彈、橡膠子彈及布袋彈,以驅散聚集在金鐘的示威者。報導提及,警方向示威者發射至少一百五十枚催淚彈,二十輪布袋彈以及數枚橡膠子彈,造成至少七十二人受傷。從多家媒體直播可見,橡膠子彈更直射一名教師眼球,創傷嚴重,對其視力之損害非同等閒。另外,警方亦曾以數枚催淚彈包抄示威者,堵塞其退路;而當示威者被逼退守至中信大廈,警方竟朝人群中央投以催淚彈,造成數以百計的市民受傷及呼吸困難,生死攸關,不容小覷。此外,警方向一名手無寸鐵的市民,近距離發射橡膠子彈,以致其下腹嚴重受傷,情況慘不忍睹。
據多份醫學期刊綜述──如《刺針》(Lancet)[1] 及英國醫學期刊(BMJ (Open))[2],橡膠子彈乃可致命武器。同時,橡膠子彈不易操控,準確性低,有引致重傷,乃至死亡之風險。多份期刊不約而同指出,橡膠子彈不適宜用於密集人群之管制。
然而,香港警察漠視上述已知風險,仍於七月二日及七月二十一日繼續使用此類武器。在七月二十一日,警察更於鄰近民居之地,向群眾發射多輪催淚彈及橡膠子彈,當中更殃及記者。此等武器之禍害影響深重,不單有損呼吸系統,更會導致燒傷、嚴重鈍物創傷及爆炸性創傷。據媒體報導,武器造成至少十四人受傷;更有市民懼於警方之搜捕行動,而未敢求醫,致使受傷數字難以估算。
人權醫療組織(Physicians for Human Rights)醫生哈爾(Dr Rohini Haar)在接受紐約時報訪問時指出,警方對市民使用不成比例的武力,實有濫用武力之嫌。早在二零一四年,潘冬平教授[3]亦對香港警察使用催淚氣體情況深表關注,擔心催淚氣體損害市民呼吸系統。可見,催淚彈、橡膠子彈及豆袋彈等武器危害不輕,對香港市民公眾健康的損害不容置疑。
兩大醫學學院一直致力培育杏林菁英,不遺餘力。一眾醫療人員亦謹承《希波克拉底誓詞》之教誨,不論病患身份職要,一直為全人類之福祉著想,嚴守不懈。學院循循善誘,吾等縷心刻骨。誓詞薪火相傳,代代不息;缺少對生命健康之尊重,醫療人員何以自立?故此,我們一眾醫療人員懇請院長,發表聲明,呼籲香港警察:
一、避免濫用催淚彈及任何類型子彈,以免導致人命傷亡及其他不可見之損傷。
二、在使用武力時,必須顧及市民安全,並保持專業克制。
醫療人員一直存仁心,行仁術;保護市民之健康,乃至生命,吾等責無旁貸。院長為學為醫,高風峻節,茍以吾等同心同德,捍衛市民之生命健康,必見杏林春暖。
謹祝
道安
一眾醫療人員謹上
———————————————————————
Dear Professor Leung and Professor Chan,
We are a group of healthcare professionals, some of us being also graduates from the Faculty of Medicine of the University of Hong Kong and the Chinese University of Hong Kong. We are writing to express our gravest concerns over the persistent and serious threats to the health of members of the public posed by weapons deployed in crowd control by the Hong Kong Police Force (HKPF) on 12 June, 2 July and 21 July. We hereby urge the Deans of the sole Faculties of Medicine in Hong Kong to take actions in censuring the HKPF and the Hong Kong Government against the serious health risks in their crowd-control tactics.
On 12 June, as reported by multiple local and international news agencies, the HKPF fired multiple rounds of tear gas, rubber bullets and bean-bag rounds to disperse protesters in Admiralty. Over 150 canisters of tear gas, 20 bean-bag rounds and several rubber bullets have admittedly been directed at protestors which resulted in at least 72 injuries. As evident in the live reports from various media sources, a teacher suffered traumatic ocular injury causing significant vision loss when his eye was hit by a rubber bullet; hundreds of citizens suffered various degrees of injuries and respiratory distress consequential upon the numerous tear gas canisters shot at Citic Tower in Admiralty where protesters were trapped in a life-threatening space filled with tear gas; an unarmed man sustained injury in his lower abdomen when a rubber bullet was directed at him in a short distance.
According to multiple studies and reviews from high impact factor medical journals, in particular the Lancet[1] and BMJ (Open)[2], rubber bullets can be lethal. Their notorious inaccuracy and risk of severe injury and death render them inappropriate and unsafe means of force in crowd control.
However, despite the known risks of these weapons, the HKPF tenaciously deployed them on citizens on 2 July and 21 July. On 21 July, 55 canisters of tear gas, 5 rubber bullet rounds and 24 sponge bullets were admittedly shot, some without immediate warning, at protestors and even at journalists notwithstanding the numerous residential buildings and citizens in the vicinity. The use of these weapons has left members of the public with at the very least, various types of injuries and further, burns, blunt force trauma and explosive injuries. 14 injuries have by far been reported where others did not present themselves to the hospital in fear of the risk of prosecution.
Dr Rohini Haar of Physicians for Human Rights had in a recent interview told the New York Times that the force used by the HKPF was disproportionate and excessive. In Hong Kong, Professor Ronnie Poon had as early as in 2014 expressed openly his earnest concern over both the short term and long term health risks in the use of tear gas in particular to one’s respiratory system when the HKPF first fired tear gas at Hong Kong citizens [3]. It is indisputable that these named weapons put the health of Hong Kong citizens at serious risks.
Doctors have striven to stand by the Hippocratic oath that they remain members of society, the identity of which comes before their profession, with special obligations to all fellow human beings. The two medical schools in Hong Kong have been established accordingly for the nurture of healthcare professionals to serve the public with benevolent hearts and minds. This is the time to honour our oath that human life should deserve the utmost respect and to maintain by all means such noble traditions of the medical profession.
We, as healthcare professionals, therefore implore the Deans of the only Faculties of Medicine in Hong Kong, in the service of humanity with conscience and dignity, to take the lead in safeguarding the public’s health and to issue a statement to urge the Hong Kong Police Force to:
(1) refrain from using tear gas and bullets in any form on protestors to prevent further bloodshed and severe non-reversible injuries; and
(2) exercise due restraint over the use of force when handling protests and at all times, put the safety of Hong Kong citizens at the highest priority.
Regards,
A group of healthcare professionals
———————————————————
Healthcare professionals have a social responsibility to safeguard the health of members of the public. We believe that, as Deans of the faculties of medicine in Hong Kong, Professor Leung and Professor Chan bear a paramount obligation in this regard. We appeal to all healthcare professionals to join us in this petition to urge the deans to issue a statement to honour their obligation to defend the public from health risks.
—————————————————————
Petition Link: https://forms.gle/teMGNCiZPMYatVbh8
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參考資料/References
[1] Mahajna, A., Aboud, N., Harbaji, I., Agbaria, A., Lankovsky, Z., Michaelson, M., . . . Krausz, M. M. (2002). Blunt and penetrating injuries caused by rubber bullets during the Israeli-Arab conflict in October, 2000: A retrospective study. The Lancet, 359(9320), 1795-1800. doi:10.1016/s0140-6736(02)08708-1
[2] Haar, R. J., Iacopino, V., Ranadive, N., Dandu, M., & Weiser, S. D. (2017, December 01). Death, injury and disability from kinetic impact projectiles in crowd-control settings: A systematic review
[3] Professor Ronnie Poon Facebook: https://www.facebook.com/138599119760/posts/10152753050039761?s=1014598371&sfns=mo
—————————————————————
reversible中文 在 With Yumi Youtube 的最佳解答
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