吸入麻醉药与肌松：机制、谜团与最低肺泡有效浓度
Inhaled anesthetics and immobility: mechanisms, mysteries, and minimum alveolar anesthetic concentration.
作者信息
Sonner James M, Antognini Joseph F, Dutton Robert C, Flood Pamela, Gray Andrew T, Harris R Adron, Homanics Gregg E, Kendig Joan, Orser Beverley, Raines Douglas E, Trudell James, Vissel Bryce, Eger Edmond I
机构信息
*Department of Anesthesia and Perioperative Care, University of California, San Francisco, California; †Department of Anesthesiology, University of California, Davis, California; ‡Columbia University, New York, New York; §University of Texas, Austin, Texas; ∥University of Pittsburgh, Pittsburgh, Pennsylvania; ¶Stanford University, Palo Alto, California; #University of Toronto, Toronto, Canada; **Department of Anaesthesia, Harvard Medical School, Cambridge, Massachusetts; and ††Garvan Institute of Medical Research, Darlinghurst, Australia.
出版信息
Anesth Analg. 2003 Sep;97(3):718-740. doi: 10.1213/01.ANE.0000081063.76651.33.
Studies using molecular modeling, genetic engineering, neurophysiology/pharmacology, and whole animals have advanced our understanding of where and how inhaled anesthetics act to produce immobility (minimum alveolar anesthetic concentration; MAC) by actions on the spinal cord. Numerous ligand- and voltage-gated channels might plausibly mediate MAC, and specific amino acid sites in certain receptors present likely candidates for mediation. However, in vivo studies to date suggest that several channels or receptors may not be mediators (e.g., gamma-aminobutyric acid A, acetylcholine, potassium, 5-hydroxytryptamine-3, opioids, and alpha(2)-adrenergic), whereas other receptors/channels (e.g., glycine, N-methyl-D-aspartate, and sodium) remain credible candidates.
利用分子建模、基因工程、神经生理学/药理学以及全动物进行的研究，增进了我们对于吸入性麻醉剂在何处以及如何通过作用于脊髓来产生麻醉作用（最低肺泡有效浓度；MAC）的理解。众多配体门控通道和电压门控通道可能介导MAC，某些受体中的特定氨基酸位点可能是介导的候选位点。然而，迄今为止的体内研究表明，一些通道或受体可能不是介导因子（例如γ-氨基丁酸A、乙酰胆碱、钾离子、5-羟色胺-3、阿片类药物以及α₂肾上腺素能受体），而其他受体/通道（例如甘氨酸、N-甲基-D-天冬氨酸以及钠离子通道）仍然是可信的候选者。
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