Balanced anesthesia (compound anesthesia, combined anesthesia) is relative to a single anesthesia, the so-called single anesthesia is simply using a single anesthetic or a single anesthetic method to complete the surgery. But a single anesthesia has many shortcomings such as: epidural anesthesia plane is not enough to pull the response, inhalation anesthesia and difficult to achieve myocardial relaxation, a single to achieve myocardial relaxation is bound to be inhibited, ketamine, fentanyl analgesia good but not myocardial relaxation. Ketamine and fentanyl are good for analgesia but not for myorelaxation. They are especially not suitable for compound surgery and so on. Liang Shan County People’s Hospital Department of Anesthesiology Shi Yizhen Balanced anesthesia: mainly according to the requirements of surgery and the characteristics of the disease to choose a reasonable choice of anesthetics or choose several appropriate anesthesia in advance to combine, so that the operation can be completed successfully, the patient can be safe and less harmful. This is one of the characteristics of modern anesthesia, so this kind of anesthesia is widely used clinically. The four elements of balanced anesthesia: 1, pain relief, 2, sedation, 3, muscle relaxation, 4, reasonable coordination of drugs, pain relief, sedation, muscle relaxation is actually a requirement for all anesthesia, and is not limited to balanced anesthesia, which is different from other anesthesia, mainly in the fourth element, reasonable deployment of anesthetic drugs and anesthesia. In other words, for different types of diseases and conditions, we should select the anesthetics with moderate doses and carefully observe the reactions after using the drugs and deal with them in time; according to the surgical process, we should grasp the timing and use the drugs reasonably, such as cutting the skin to highlight the pain relief, opening and closing, and we should pay attention to the muscle relaxation. Therefore, the overall goal of balanced anesthesia can closely cooperate with surgery and strive to maintain the stability and balance of the internal environment of the patient’s body. The concept of balanced anesthesia: the way of thinking of anesthesiologists is between medical and surgical physicians, such as: internal medicine physicians focus on the pathogenesis of disease, symptoms and signs, specializing in the diagnosis and differential diagnosis of disease; surgeons focus on the localization of disease and surgical indications, while anesthesiologists as (internal and surgical physicians in the operating room) focus more on surgical indications and surgical procedures, focusing on the patient’s systemic condition, the functional status of important organs, and the ability to compensate. status, and compensatory capacity. With the above thinking, the concept of balanced anesthesia is proposed. 1.Psychological balance Preoperative visit to understand the requirements of patients and families, and explain the anesthesia process to obtain their trust and cooperation, to meet the requirements of different surgeons, anesthesiologists should improve their own training to treat each case of anesthesia seriously, to anesthetize patients and meet the requirements of surgeons with a calm psychological state. 2, the balance of surgery and anesthesia: anesthesia work itself is to meet the needs of surgery, to be familiar with the steps of surgery according to the needs of surgery and surgeons to choose the method of anesthesia and adjust the depth of anesthesia, carefully do a good job of preoperative preparation is the guarantee of anesthesia safety, so to meet the needs of surgery without losing the principle of anesthesia. 3. Balance of compensatory capacity of important organs and anesthetic influence: In addition to organic lesions of heart, lung, brain, kidney and liver, understand their functional status and medication, avoid the influence of anesthetic drugs and methods on important organs intraoperatively, so that they always maintain a good functional status. 4.Balance of internal environment Body fluid balance, electrolyte and acid-base balance, body heat loss and insulation (balance of heat production), balance of energy supply and consumption, balance of oxygen supply and demand, suspicious and anti-suspicious blood, blood loss and transfusion, infection and anti-infection, sympathetic and parasympathetic balance, and endocrine balance, etc. 5.Stability of vital signs The balance of the internal environment and autonomic nervous system is the basis of the stability of vital signs, the relationship between blood pressure and heart rate, urine volume, respiration, body temperature, eye signs and reflexes, and the stability of the vital signs of the responders. 6 Balance of anesthesia depth and adverse stimuli Understand the characteristics of each surgery and surgeon, pay close attention to the surgical steps, and actively adjust the depth of anesthesia according to the intensity of surgical stimuli. 7 Balance of anesthetics (interaction) Balance of anesthesia, balance of different anesthetic drugs and methods in combined anesthesia, balance between emergency (resuscitation) drugs, and balance with anesthetic drugs, pay attention to the factors affecting drug use, age, body temperature, expectancy, heart (circulation), lungs (inhalation of anesthetics), liver, kidney (elimination with drugs) and other functional states. 8, the balance of the autonomic nervous system, that is, the balance of sympathetic and parasympathetic nervous system, can cause nervous activity, central nervous and reflex mechanisms to regulate, increase or decrease the blood flow and function of regulatory organs in response to various stimuli (pharmacological, physiological and environmental); the application of drugs during anesthesia, painful stimuli and half with the disease (such as hypertension, diabetes mellitus, coronary heart disease) can affect the sympathetic and parasympathetic reflex activity of the sympathetic and parasympathetic nerves.