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<meta name="description" content="AI導入や遠隔医療，環境負荷といった現代の重要課題も取り上げ，全面的に刷新した大好評書の改訂版 ．医学生からベテランまでが直面する「今さら聞けない」108の疑問に対し，エビデンスと実践的アドバイスをQ&amp;A形式で提示する ．単なる知識の提示に留まらず，自らの臨床を振り返る「鏡」となる一冊であり，日々の管理から教育のあり方まで，臨床現場の最適解を模索する全ての麻酔科医に贈る実践知の宝庫である．">

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		<h1 class="catchCopy">大好評書の初版を完全改訂．臨床のリアルと「今」の最適解を示すQ&A決定版！</h1>
		

		<h1 class="copy">今さら聞けない</h1>
		<h1 class="title">麻酔科の疑問108<span class="version">第2版</span></h1>
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					監修：山蔭道明（札幌医科大学教授）
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		<div class="headers"><h3 class="current content">内容</h3><h3 class="indexes">主要目次</h3></div><section class="current content">AI導入や遠隔医療，環境負荷といった現代の重要課題も取り上げ，全面的に刷新した大好評書の改訂版 ．医学生からベテランまでが直面する「今さら聞けない」108の疑問に対し，エビデンスと実践的アドバイスをQ&A形式で提示する ．単なる知識の提示に留まらず，自らの臨床を振り返る「鏡」となる一冊であり，日々の管理から教育のあり方まで，臨床現場の最適解を模索する全ての麻酔科医に贈る実践知の宝庫である．</section><section class="indexes">第1章 基本の「き」･･いまさら聞けない基礎知識<br>　Question 001 全身麻酔は「不安を取るだけ」ではないって本当? <br>　Question 002 「MAC」ってなんですか? 今でも目安に使うのですか? <br>　Question 003 TIVA と吸入麻酔、どう選びますか? <br>　Question 004 筋弛緩薬は麻酔薬の一部ですか? <br>　Question 005 覚醒時のせん妄、何が原因ですか? <br>　Question 006 術中覚醒はありますか? <br>　Question 007 モニターで一番大切なのはどれですか? <br>　Question 008 鎮静と麻酔はどう違いますか? <br>　Question 009 麻酔導入時の腕の「ピリピリ感」はいったい何? <br>　Question 010 覚醒はどうやって起こっているの? <br>第2章 気道・換気 酸素化<br>　Question 011 マスク換気がうまくいかない時の工夫は? <br>　Question 012 ビデオ喉頭鏡と直接喉頭鏡、どちらを選ぶ? <br>　Question 013 挿管チューブのサイズは何を基準に選ぶ? <br>　Question 014 カプノグラムでは何を見ていますか? <br>　Question 015 困難気道をどう見抜きますか? <br>　Question 016 経鼻挿管を上手にできるようになるには? <br>　Question 017 喉頭痙攣の初期対応は? <br>　Question 018 気管支鏡、どのように習う? そして教える? <br>　Question 019 気道抵抗が大きく変化した時、どう対応するか? <br>　Question 020 術後の咽頭痛・嗄声を防ぐには? <br>第3章 循環管理<br>　Question 021 麻酔導入で血圧を上げない、下げない方法はありますか? <br>　Question 022 ノルアドレナリンとフェニレフリンは、どう使い分ける? <br>　Question 023 術中頻脈の対応は? <br>　Question 024 輸液量、どうやって決めていますか? <br>　Question 025 肺動脈カテーテルを使うタイミングは? <br>　Question 026 中心静脈カテーテル、PICC、ミッドラインカテーテルの棲み分けは? <br>　Question 027 術中の高乳酸血症、どうする? <br>　Question 028 血圧が正常なのにショックってあるんですか? <br>　Question 029 低侵襲血行動態モニターはいつ使う? <br>　Question 030 麻酔科医が覚えておくべき心エコースキルは? <br>第4章 麻酔薬と薬理<br>　Question 031 プロポフォールとケタミン、併用する理由は? <br>　Question 032 レミフェンタニル中止後のリバウンド痛は本当? そしてどう対応する? <br>　Question 033 スガマデクスの正しい使い方は? <br>　Question 034 術中鎮痛の判断はどのようにしている? <br>　Question 035 悪性高熱症を予防するためには? <br>　Question 036 抗コリン薬はどのような時に有効? <br>　Question 037 吸入麻酔薬の環境への影響はどれほど? <br>　Question 038 小児と高齢者の麻酔薬の量 なぜ違う? なぜ同じ? <br>　Question 039 TIVAでの麻酔深度評価、どうしていますか? <br>　Question 040 レミマゾラムはどう使う? <br>第5章 周術期管理<br>　Question 041 絶飲食、何時間空ければいいの? <br>　Question 042 術前に中止すべき薬と継続すべき薬は? <br>　Question 043 PONV予防薬,何を基準に選ぶ? <br>　Question 044 術後鎮痛、PCAと非オピオイドどちらがよい? <br>　Question 045 術前の予防接種、どうする? <br>　Question 046 術後発熱、感染症以外の原因は? <br>　Question 047 術後呼吸管理で問題があった場合は? <br>　Question 048 麻酔管理中の体温低下・体温上昇への対応は? <br>　Question 049 術後合併症はいつ生じやすいか? <br>　Question 050 ICUへの引き継ぎで大切なことは? <br>第6章 患者背景と個別対応<br>　Question 051 高齢者の麻酔で神経系に関して注意することは? <br>　Question 052 小児麻酔で特に注意することは? <br>　Question 053 肥満患者の麻酔で気をつける点は? <br>　Question 054 心疾患合併患者をどのように評価、対応する? <br>　Question 055 腎機能障害がある患者では麻酔薬を変えるべき? <br>　Question 056 肝疾患患者に吸入麻酔薬は避けるべき? <br>　Question 057 神経疾患合併症例に筋弛緩薬はどう使う? <br>　Question 058 抗凝固薬を服用中の患者の対応は? <br>　Question 059 これからの術前診察のあり方は? <br>　Question 060 透析患者の術前評価のポイントは? <br>第7章 局所麻酔・神経ブロック<br>　Question 061 局所麻酔薬中毒(LAST) の対応策は? <br>　Question 062 超音波ガイド下神経ブロックの利点は? <br>　Question 063 末梢神経ブロックが効かない時の対応は? <br>　Question 064 硬膜外麻酔と脊髄くも膜下麻酔、どう使い分ける? <br>　Question 065 高位脊髄くも膜下麻酔が起こったら? <br>　Question 066 局所麻酔薬はどのくらいの量まで使える? <br>　Question 067 神経ブロックを行う際に事前にチェックすべきことは? <br>　Question 068 神経刺激法とエコー法、併用すべき? <br>　Question 069 術後鎮痛に神経ブロックはどこまで有効? <br>　Question 070 血腫のリスクが高い患者にブロックは可能? <br>第8章 特殊手術対応<br>　Question 071 腹腔鏡下手術で換気に注意すべき理由は? <br>　Question 072 ロボット支援下手術での麻酔の注意点は? <br>　Question 073 帝王切開の麻酔は脊髄くも膜下麻酔のみ? それとも脊髄くも膜下+硬膜外麻酔? <br>　Question 074 覚醒下開頭手術の麻酔管理はどう行う? <br>　Question 075 脊髄損傷患者の麻酔の注意点は? <br>　Question 076 整形外科手術で神経ブロックを使う理由は? 注意点は? <br>　Question 077 外傷患者の緊急手術麻酔で優先すべきことは? <br>　Question 078 小児の整形外科手術、何に注意する? <br>　Question 079 日帰り手術での麻酔の条件とは? <br>　Question 080 心疾患合併高齢者の骨折手術、ブロックは必須? <br>第9章 術中イベントや術後対応<br>　Question 081 術中心停止の原因は? <br>　Question 082 アナフィラキシーの徴候は? <br>　Question 083 術後に気道が閉塞する原因は? <br>　Question 084 神経ブロック後の神経症状にどう対応する? <br>　Question 085 術中アラーム音、どれが最も重要? <br>　Question 086 術中出血が多い時、輸血のタイミングは? <br>　Question 087 術後ICU入室の適応は? <br>　Question 088 術後せん妄が発症した。どう対応する? <br>　Question 089 抜管に迷う時･･･ さて、どうする? <br>第10章 AIと時代の変化<br>　Question 090 AIは麻酔科医の代わりになる? <br>　Question 091 自動投与装置はどこまで信用できる? <br>　Question 092 遠隔麻酔は現実的に可能か? 集中治療は? <br>　Question 093 麻酔記録の電子化で注意すべきことは? <br>　Question 094 AIによる麻酔深度予測は正確か? <br>　Question 095 多職種医療者とどう連携をとる? <br>　Question 096 働き方改革と麻酔の質、両立できる? <br>　Question 097 感染流行時の麻酔戦略は? <br>　Question 098 サステナブルな麻酔のあり方とは? <br>　Question 099 AIツールを麻酔業務に活かすには? <br>第11章 キャリアと教育<br>　Question 100 シミュレーション教育は実際に役立つ? <br>　Question 101 若手が成長する環境とは? <br>　Question 102 専門医を取った後の進路は? <br>　Question 103 麻酔科医が燃え尽きないためには? <br>　Question 104 初期研修医に麻酔を教える際のコツは? <br>　Question 105 女性麻酔科医のキャリア支援は? <br>　Question 106 海外研修・研究で得られるものは? <br>　Question 107 教育と研究、どう両立する? <br>　Question 108 これからの麻酔科医のあり方は?<br>終章 Message 108の「迷い」とともに生きる、麻酔科医という道<br><br>［ワンポイント・コラム］<br>　•“ただ眠らせる人”ではない、麻酔科医の矜持 <br>　•麻酔科医はTIVAと吸入麻酔の二刀流たるべし! <br>　•森岡亨先生の自家実験にみる麻酔科創成期の精神 <br>　•覚醒時せん妄に直面したとき一回復を“待つ力”の重要性 <br>　•五感で感じる「生きた情報」 <br>　•「ルート漏れてないですか?!」一後輩麻酔科医が教えてくれた導入時痛の現実 <br>　•覚醒は「術後の第一印象」を決める瞬間 <br>　•ビデオ喉頭鏡をルーチンで使いながら直接喉頭鏡の修練をするには <br>　•意識下挿管を選択するケース <br>　•経鼻挿管における「咽頭後壁迷入」の回避 <br>　•The Laryngospasms <br>　•シミュレーションやハンズオンの機会をもっと活用しよう! <br>　•安易かつ過剰な血管収縮薬の投与に注意 <br>　•超音波装置を使いこなそう! <br>　•悪性高熱症にどこまで備えるか <br>　•環境に優しい麻酔を目指して一まずは正しい理解から <br>　•麻酔と脳:成長と老化に伴うリスクと安全性 <br>　•バランス麻酔の指標として <br>　•迅速導入の考え方は? <br>　•何を飲んだのかを確認しよう <br>　•中止すべき薬を中止できなかったときは? <br>　•術後の予防接種、どうする? <br>　•中枢温って何のこと? <br>　•抜管後すぐの再挿管 <br>　•悪性高熱症との鑑別 <br>　•コミュニケーションを大切に <br>　•PNDの分類一術後せん妄~認知症の違いは? <br>　•【導入編】私の流儀: 自発呼吸が残っている間は「マスク換気しない」 <br>　•【抜管編】私の流儀: 麻薬性の呼吸パターンでは「抜管しない」 <br>　•末梢静脈と中心静脈の間=ミッドライン <br>　•筋弛緩モニターの落とし穴 <br>　•大量出血への備え、CVがあればいい? <br>　•共感の難しさと大切さ <br>　•透析カテーテルは誰が挿入する? <br>　•LASTのリスクは皆同じ?････ <br>　•超音波ガイド下神経ブロックの魅力は患者アウトカムの向上にあり <br>　•ハイリスク症例における「飛び道具」としての神経ブロック <br>　•SAとEAの「いいとこどり」-DPE <br>　•「安心」という名の麻酔 <br>　•神経刺激法にも慣れておきたい <br>　•乏尿に対する輸液負荷 <br>　•RBCとFFPの投与比率 <br>　•トラネキサム酸の効果 <br>　•小児にも積極的にかかわって <br>　•日帰り麻酔で最も重要な麻酔薬は「局所麻酔薬」 <br>　•ブロックに使う局所麻酔薬の濃度 <br>　•神経ブロックをコントロールすることの重要性―医療安全の立場から <br>　•バルスオキシメータは周術期患者の予後を改善したのか? <br>　•その患者さん、術後ICUじゃなくて大丈夫? <br>　•高齢者における術後せん妄 <br>　•覚醒、抜管における4つのMUSTと「3つ」の要素 <br>　•現時点での自動制御システム <br>　•麻酔深度とは? <br>　•手術室は「航空管制塔」、連携はリアルタイムに <br>　•自分がいなくても回る仕組みこそ、真の専門性 <br>　•未来の患者のための「もうひとつの安全性」 <br>　•お掃除ロボットがあったら <br>　•臨床現場で使えるデブリーフィング (GAS法) <br>　•自分の成長を、誰かが信じてくれている一それがすべての出発点 <br>　•麻酔科医が集中治療を行う意義 <br>　•誰かにとって、働き続けるあなたの姿が「希望」になる <br>　•研修医に一人で麻酔管理をさせて大丈夫? <br>　•麻酔と循環管理 <br>　•AIが医師の働き方を変える? <br>　•他国から日本を見た日、自分の輪郭が浮かび上がる <br>　•教える人が最も学ぶ、問い続ける人が最も育つ <br>　•麻酔科医は「未来を託される職業」である<br></section></article>
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