跟讀練習: Anesthesiology: Basics – Anesthesiology | Lecturio - 通過影片學習英語口語

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Hello ladies and gentlemen.

Here are a series of questions and answers to start you thinking about anesthesiology.

I'll follow that with a short history of the specialty and a discussion on how anesthesiology has changed the world.

A common question I'm asked and it's a reasonable question.

I've been told that I will be asleep during my surgery.

I don't think surgery could be performed on me if I were just asleep.

Is general anesthesia the same as sleep?

General anesthesia is not just deeper sleep.

It's much better compared to a state of reversible coma.

It's a type of coma that we can induce and we can reverse, and yes, we can reverse it,

and you will wake up from your anesthetic.

The second common question I'm asked is, I've been told that I will be paralyzed during my surgery.

Isn't this dangerous?

How will I breathe?

This statement is often accompanied by my students with statements like, that's really gross and how would you do that to people?

The answer is you may be paralyzed during your surgery

if the surgeon requires muscle relaxation to complete the surgery successfully

and safely or if the anesthesiologist must place a breathing tube in your trachea.

The anesthesiologist is responsible for managing your breathing and will make sure that you have no memory for this whole experience.

Third question that's commonly asked is, will I remember being operated upon?

You will remember entering the operating room and being introduced to the team members

that are going to be involved in your surgery.

You will then be given an anesthetic, which will eliminate all memory of the surgical experience itself.

And you will not be awakened, and you will not reform your memory until the surgery is completed.

After the anesthetic is gone, won't I have a lot of pain?

When anesthesia is properly delivered, the provider assures that pain prevention is an important aspect of the care.

Before the end of surgery, the anesthesiologist will provide you with painkillers that will produce good pain relief when you wake up.

In addition, the nurses in the recovery room will give you additional pain relief if you require it.

So here's a definition from the Oxford Dictionary.

It's not sleep.

Surgery cannot be performed under conditions of normal sleep.

Period.

And the Oxford Dictionary says, An anesthetic that affects the whole body and it usually causes a loss of consciousness,

i .e., he had an operation under general anesthesia.

Anesthesia.

The critical word here is a reversible drug -induced state of unconsciousness, which is characterized by a coma -like state under the control of the anesthetist,

a term that is also known as anesthesiologist, depending on what part of the world you're in.

It's often associated with muscle paralysis.

It's always associated with profound amnesia for the surgical event.

So how did anesthesia develop?

Well, it's all thanks to the dentists.

Doctors can't take any credit for it.

Prior to 1846, there was no known way to provide anesthesia to those undergoing surgery.

The whole process of surgery was extraordinarily painful, bloody and dirty.

Surgeons were praised for the speed, not skill, in their sexful completions of operations.

Surgical procedures were either very superficial, drainage of abscesses or removal of small skin lesions, or major amputations of limbs,

caesarean section, all without any anesthesia.

The Massachusetts General Hospital, at the time that this whole event occurs, was the busiest surgical site in North America.

It provided surgical procedures to an average of five patients a week.

After 1846, longer, more complex surgical procedures developed,

and the field of surgery exploded.

Now over 100 procedures are done at Massachusetts General Hospital a day,

and new surgical procedures are being developed at a very rapid pace.

So the first dentist we're going to talk about is Dr. Horace Wells.

He's the real father of anesthesiology, although the term's been used on many individuals.

Yes, he was a dentist.

In 1844, he went to a party.

It was a nitrous oxide party where people gathered and enjoyed themselves and breathed nitrous oxide,

usually out of a big paper bag.

And one of the things he noticed was a woman smashed her leg very hard against a bench

and ended up with a large laceration on her leg, which should have been extremely painful.

She had no sense of pain whatsoever from it.

And from this observation, he then went about using nitrous oxide in his dental practice.

He had his own tooth extracted under nitrous oxide anesthesia and had very little discomfort.

And in 1845, he demonstrated nitrous oxide for surgical anesthesia at the Massachusetts General Hospital.

Unfortunately, as you're going to learn in this course, nitrous oxide is not a strong anesthetic.

And it was a dismal failure.

And he was shamed before all the physicians in Massachusetts and the dentists.

Nitrous oxide provides good analgesia, good pain control, but cannot provide full anesthesia.

So the patient cried out during the surgery, Wells was humiliated, and he ultimately committed suicide.

This was a typical advertisement in those days for a laughing gas party, nitrous oxide party.

So you can see, laugh, sing, dance, speak, or fight, all those wonderful things you could do with nitrous oxide on board.

So the next dentist to come along was Dr. William Morton, also in Massachusetts.

He had actually been predated by Dr. Crawford Long in Great Britain, who did do surgery under ether anesthesia, but didn't bother publishing his results.

So the first described and known event in general anesthesia occurred on October 16, 1845.

Dr. Morton provided anesthesia to a young man having a tumor removed from his neck under ether anesthesia.

And the chief surgeon turned to the crowd in the room and said, in the very pompous way of that

Victorian era, gentlemen, this is no humbug.

And Morton's name was made.

Morton was a bit of a scamp,

unfortunately, and he tried to make more out of this than he was able to by coloring ether orange

and then trying to patent it as orange ether,

claiming it was superior to regular ether that had actually been around as a solvent and cleaning agent for centuries.

So this is a painting of that first event and this is from 1845 at the Massachusetts General.

This operating room is still in existence and you can visit it if you wish,

but you can see how very different the world was then than it is now.

All these people gathered around the operating room table wearing street clothes.

They may, in fact, be people right off the street because like public executions,

surgery was a popular spectator sport in the mid part of the 19th century.

You can see Morton holding his bottle of ether and the surgeon working on the young man's neck.

So that started general anesthesia for general surgery.

But it was important to move beyond that to other areas of need.

And the area that was likely to be missed in all of this was obstetrical anesthesia.

Partly this was due to the biases of the era that said,

you know, pain during labor was a required part of woman's recompense for original sin.

Well, there was a very powerful lady in existence in that era in Great Britain.

That was Queen Victoria.

And she wasn't willing to be punished for something that might have happened in the Garden of Eaton.

And with her eighth child, she had 11, I believe, she asked Dr. John Snow,

100

who was the first practicing anesthesiologist in Great Britain, to provide her with anesthesia.

101

Snow's an interesting man.

102

And for those of you who are aware of the London pump cholera story,

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it's the same John Snow who discovered that pump and was able to prevent cholera from spreading in London.

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And so in a way, he's the father of epidemiology, and he's also one of the fathers of anesthesiology.

105

Very amazing man.

106

Anyway, after she delivered her baby, Queen Victoria said, Dr. Snow gave the blessed chloroform, and the effect was soothing,

107

quieting, and delightful beyond measure.

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And from that moment forward, obstetrical anesthesia had a solid place in medicine.

109

So this is what it looked like to start with.

110

This is a bottle of ether and a Schimmelbush mask.

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And the mask is basically just a wire mask that you laid some gauze over,

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and you poured ether directly on the gauze and put the mask

113

and gauze over the patient's face and they breathe the vapor.

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This is a modern anesthetic machine, a little bit fancier than the Schimmel -Busch mask,

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much more sophisticated, full of very complex warning systems and monitoring systems, which we'll discuss in more detail in a later lecture.

116

Other forms of anesthesia that have developed include regional anesthesia, which developed as local anesthetics were created,

117

and one of the first people involved in this story was Sigmund Freud, who thought that cocaine would be both a useful medication

118

and felt that it would be particularly useful in the treatment of depression.

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And unfortunately, Sigmund Freud had to withdraw this belief in a later period because one of his best friends,

120

who was a very famous American surgeon, became addicted to cocaine and died from its use.

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In any case, the use of cocaine and other simple local anesthetics led to the development of spinal and epidural anesthesia.

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And we can now provide complete loss of sensation to many parts of the body, and particularly the limbs, for surgery.

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Spinal anesthesia is the commonest form of anesthesia for cesarean sections,

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for instance, whereas epidural anesthesia is useful for pain relief during labor or after certain types of surgery.

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Spinal anesthesia is often used for surgery of the legs.

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With modern ultrasound equipment, it is now possible to pass a needle directly to a nerve without perforating the nerve

127

or hitting blood vessels under direct vision using ultrasound.

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And this has revolutionized the use of regional anesthesia over the last 5 to 10 years.

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Anesthesia is an extremely safe medical specialty.

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It's one of the safest interventions in modern medicine.

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My practice started in 1980.

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At that time, people used to die on the operating room table.

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In 2014, it's extraordinarily rare for this to happen.

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In developed countries, the mortality rate from general anesthesia is usually stated to be around 1 in 10 ,000

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or maybe as high as 1 in 20 ,000.

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The rate is much lower, however, in young, healthy individuals.

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Also in developed countries, the rate of permanent neurologic damage from spinal or epidural anesthesia is less than 1 in 100 ,000.

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So in a career, most anesthesiologists will never see this happen.

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So our lecture series is going to be laid out like this.

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An introductory lecture, which you're hearing now, a lecture on physiologic aspects of anesthesia, drugs used in anesthesia, and anesthetic systems.

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We'll then move into the more clinical aspects of the specialty and talk about general anesthesia, regional anesthesia, emergencies in the operating room,

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intensive care of patients, pain management, and anesthesia for special populations such such as the pregnant patient,

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children, thoracic anesthesia, neuroanesthesia.

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And then at the very end, we'll summarize everything and we'll have a short discussion about anesthesia and its use in other medical disciplines,

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and the future of anesthesia, and some of the opportunities for young anesthesiologists opening into the future.

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So in this lecture, we've summarized the history of anesthesiology

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and given you a bit of an overview of what general anesthesia and regional anesthesia look like.

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We're going to go into a great more detail in the subsequent lectures, and I hope you join us for those.

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本課的詞彙與口語要點

這節口語課以影片“Anesthesiology: Basics – Anesthesiology”為素材。影片中反覆出現的詞有：anesthesia, surgery, anesthetic, nitrous, oxide。這段影片共有 148 個句子、1942 個單詞可供跟讀。講話部分時長為 13:33。說話人語速平穩，每分鐘約 143 個詞，很適合跟讀。只有 79% 的單詞屬於英語最常用的 3,000 詞，詞彙難度較高。

影片中的重點詞彙

影片中 15 個值得學習的單詞，附發音和釋義：

單詞	發音	釋義
oxide 名詞	/ˈɑksaɪd/	氧化物
lecture 名詞	/ˈlɛk.t͡ʃə/	演講 /演講
procedure 名詞	/pɹəˈsiː.d͡ʒə/	做法, 方法
mask 名詞	/mæsk/	面具, 面罩
breathe 動詞	/bɹiːð/	呼吸, 吸
surgeon 名詞	/ˈsɝd͡ʒən/	外科醫生 /外科醫生
dentist 名詞	/ˈdɛntɪst/	牙醫 /牙醫, 牙科醫生 /牙科醫生
spinal 形容詞	/spaɪ.nəl/	脊的
aspect 名詞	/ˈæspɛkt/	方面
cocaine 名詞	/koʊˈkeɪn/	可卡因, 古柯鹼 /古柯鹼
specialty 名詞	/ˈspɛʃ.əl.ti/	專業 /專業, 專長 /專長
coma 名詞	/ˈkoʊmə/	昏迷, 昏睡
muscle 名詞	/ˈmʌs.əl/	肌肉, 筋肉
asleep 形容詞	/əˈsliːp/	睡著的, 睡著的
painful 形容詞	/ˈpeɪn.fl̩/	痛苦的, 疼痛的

影片中出現的短語動詞

單詞	發音	釋義
come along 動詞		陪伴, 陪同
wake up 動詞	/ˌweɪk ˈʌp/	醒, 醒來 /醒來

值得反覆跟讀的句子

影片中簡短而完整的句子，可以直接用在日常對話裡：

How will I breathe?
Third question that's commonly asked is, will I remember being operated upon?
After the anesthetic is gone, won't I have a lot of pain?

影片中的語法

說話人最常用的結構，並附上影片中的原話：

結構	影片中的用法
被動語態 be + 過去分詞 — 強調發生了什麼，而不是誰做的	I've been told · could be performed · is often accompanied
現在完成時 have/has + 過去分詞 — 過去發生但與現在仍有關聯的事	has changed · I've been told · term's been
定語從句 who / which + 從句 — 補充說明人或事物	anesthetic, which will · unconsciousness, which is

需要注意的發音

說話人用了 21 次縮略和弱讀形式，例如 we'll, you're, I'm。請按聽到的簡短形式來說。

“th” 音: breathe /bɹiːð/, gather /ˈɡæðɚ/, bother /ˈbɑðɚ/, eighth /eɪtθ/, tooth /tuθ/
“sh” 和 “zh” 音: specialty /ˈspɛʃ.əl.ti/, execution /ˌɛk.sɪˈkjuː.ʃən/, prevention /pɹɪˈvɛnʃən/, intervention /ɪntɚˈvɛnʃən/, completion /kəmˈpliː.ʃən/
長單詞——注意重音位置: superior /sʊˈpɪɹ.i.ɚ/, successfully /səkˈsɛs.fə.li/, execution /ˌɛk.sɪˈkjuː.ʃən/, intervention /ɪntɚˈvɛnʃən/, eliminate /ɪˈlɪm.ɪ.neɪt/

中文母語者容易讀錯的音：

/v/ — 不要讀成 /w/，上齒輕觸下唇: reverse /ɹɪˈvɝs/, nerve /nɝv/, removal /ɹɪˈmuː.vəl/, prevention /pɹɪˈvɛnʃən/, vessel /ˈvɛsəl/
詞尾子音 — 要讀清楚，後面不要加母音: oxide /ˈɑksaɪd/, mask /mæsk/, dentist /ˈdɛntɪst/, aspect /ˈæspɛkt/, reverse /ɹɪˈvɝs/
/r/ 和 /l/ 的區別: ultrasound /ʌl.tɹə.saʊnd/, removal /ɹɪˈmuː.vəl/, partly /ˈpɑɹtli/, mortality /mɔɹˈtælɪti/, relaxation /rᵻˌlækˈseɪ.ʃən/

如何用這段影片練習

先完整聽一遍影片，不要開口，記下不認識的單詞。
用正常速度逐句跟讀，每句重複到你的節奏與說話人一致為止。
錄下自己的聲音並與原聲對比，特別注意 oxide, lecture, procedure 這類單詞。

什麼是跟讀法？

跟讀法 (Shadowing) 是一種有科學依據的語言學習技巧，最初開發用於專業口譯員的培訓，並由多語言者Alexander Arguelles博士普及。這個方法簡單而強大：您在聽英語母語原聲的同時立即大聲重複——就像是一個延遲1-2秒緊跟說話者的影子。與被動聽力或語法練習不同，跟讀法強迫您的大腦和口腔肌肉同時處理並模模擬實的講話模式。研究表明它能顯著提高發音準確性，語調，節奏，連讀，聽力理解和口語流利度——使其成為雅思口語備考和真實英語交流最有效的方法之一。

影子跟讀法: 閱讀完整分步指南 →

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