Loscar M, Conzen P
Klinik für Anaesthesiologie der Ludwig-Maximilians-Universität München, München.
Anaesthesist. 2004 Feb;53(2):183-98. doi: 10.1007/s00101-003-0632-6.
None of the currently available inhaled anesthetics has all of the properties of an "ideal" inhaled agent. The exceptionally low solubility of desflurane and sevoflurane offers a significantly greater precision of control over maintenance of anesthesia and a potential for a more rapid recovery from anesthesia than other inhaled anesthetics. Sevoflurane appears to offer some advantages regarding cardiovascular stability. Products of metabolism or degradation can be associated with potential organ-specific toxic effects. Renal toxicity is discussed for enflurane and sevoflurane. Breakdown products of volatile agents with carbon dioxide absorbents have to be mentioned especially for sevoflurane (compound A) and desflurane (CO). In contrast to intravenous anesthetics, volatile anesthetics are associated with cardio- and cerebroprotection.
目前可用的吸入麻醉剂均不具备“理想”吸入麻醉剂的所有特性。地氟烷和七氟烷极低的溶解度使得在麻醉维持控制方面具有更高的精确度,且与其他吸入麻醉剂相比,具有更快从麻醉中恢复的潜力。七氟烷在心血管稳定性方面似乎具有一些优势。代谢或降解产物可能会产生潜在的器官特异性毒性作用。已讨论了恩氟烷和七氟烷的肾毒性。尤其对于七氟烷(化合物A)和地氟烷(一氧化碳),必须提及挥发性麻醉剂与二氧化碳吸收剂的分解产物。与静脉麻醉剂不同,挥发性麻醉剂具有心脏和脑保护作用。