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  • If you've had surgery, you might remember starting to count backwards from ten, nine, eight,

    假如你曾接受手術你可能還記得從十開始倒數, 九、八、

  • and then waking up with the surgery already over before you even got to five.


  • And it might seem like you were asleep, but you weren't.


  • You were under anesthesia, which is much more complicated.

    你被麻醉了,這比 「睡著」複雜多了 。

  • You were unconscious, but you also couldn't move, form memories, or, hopefully, feel pain.


  • Without being able to block all those processes at once, many surgeries would be way too traumatic to perform.


  • Ancient medical texts from Egypt, Asia and the Middle East all describe early anesthetics, containing things like opium poppy, mandrake fruit, and alcohol.

    來自埃及、亞洲及中東古老的醫學文稿都有描述早期的麻醉藥含有像罌粟、 曼德拉草果實、及酒精的成分。

  • Today, anesthesiologists often combine regional, inhalational and intravenous agents to get the right balance for a surgery.


  • Regional anesthesia blocks pain signals from a specific part of the body from getting to the brain.


  • Pain and other messages travel through the nervous system as electrical impulses.


  • Regional anesthetics work by setting up an electrical barricade.


  • They bind to the proteins in neurons' cell membranes that let charged particles in and out and lock out positively charged particles.


  • One compound that does this is cocaine, whose painkilling effects were discovered by accident when an ophthalmology intern got some on his tongue.


  • It's still occasionally used as an anesthetic, but many of the more common regional anesthetics have a similar chemical structure and work the same way.


  • But for major surgeries where you need to be unconscious, you'll want something that acts on the entire nervous system, including the brain.

    但對於病人需要昏迷無知覺的重大手術將需要能作用於整個神經系統 - 包括大腦 - 的藥物。

  • That's what inhalational anesthetics do.


  • In Western medicine, diethyl ether was the first common one.


  • It was best known as a recreational drug until doctors started to realize that people sometimes didn't notice injuries they received under the influence.


  • In the 1840s, they started sedating patients with ether during dental extractions and surgeries.

    在 1840 年代,醫師開始用乙醚來鎮靜拔牙及手術的病患。

  • Nitrous oxide became popular in the decades that followed and is still used today.


  • Although ether derivatives like sevoflurane, are more common.


  • Inhalational anesthesia is usually supplemented with intravenous anesthesia, which was developed in the 1870s.

    吸入性麻醉常會額外加用靜脈注射麻醉,後者是在 1870 年代研發出來。

  • Common intravenous agents include sedatives, like propofol, which induce unconsciousness, and opioids, like fentanyl, which reduce pain.


  • These general anesthetics also seem to work by affecting electrical signals in the nervous system.


  • Normally, the brain's electrical signals are a chaotic chorus as different parts of the brain communicate with each other.


  • That connectivity keeps you awake and aware.


  • But as someone becomes anesthetized, those signals become calmer and more organized, suggesting that different parts of the brain aren't talking to each other anymore.


  • There's a lot we still don't know about exactly how this happens.


  • Several common anesthetics bind to the GABA-A receptor in the brain's neurons.

    許多常用的麻醉劑會與大腦神經元的 GABA-A 受體結合。

  • They hold the gateway open, letting negatively charged particles flow into the cell.

    它們維持通道開放讓帶負電的粒子流入細胞內 。

  • Negative charge builds up and acts like a log jam, keeping the neuron from transmitting electrical signals.

    負電堆積就好像原木堵塞阻斷神經元電子訊號傳送 。

  • The nervous system has lots of these gated channels, controlling pathways for movement, memory, and consciousness.

    神經系統有許多這種門控通道用來控制運動、 記憶、 及意識的路徑 。

  • Most anesthetics probably act on more than one, and they don't act on just the nervous system.


  • Many anesthetics also affect the heart, lungs, and other vital organs.

    許多麻醉劑也會影響心臟、肺臟、 及其他重要器官 。

  • Just like early anesthetics, which included familiar poisons like hemlock and aconite, modern drugs can have serious side effects.


  • So an anesthesiologist has to mix just the right balance of drugs to create all the features of anesthesia,


  • while carefully monitoring the patient's vital signs, and adjusting the drug mixture as needed.

    同時小心地監測病人的生命徵候及視需要調整混合的藥物 。

  • Anesthesia is complicated, but figuring out how to use it allowed for the development of new and better surgical techniques.


  • Surgeons could learn how to routinely and safely perform C-sections, reopen blocked arteries, replace damaged livers and kidneys, and many other life-saving operations.

    外科醫師能學會如何例行且安全地執行剖腹產手術、打通阻塞的動脈、 置換損傷的肝臟及腎臟以及許多其他挽救生命的手術。

  • And each year, new anesthesia techniques are developed that will ensure more and more patients survive the trauma of surgery.


If you've had surgery, you might remember starting to count backwards from ten, nine, eight,

假如你曾接受手術你可能還記得從十開始倒數, 九、八、

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B1 中級 中文 美國腔 TED-Ed 手術 訊號 作用 醫師 神經

【TED-Ed】麻醉藥是如何產生作用的? (How does anesthesia work? - Steven Zheng)

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    Ann 發佈於 2021 年 06 月 11 日