挥发性麻醉药的心脏保护作用：机制与临床意义
Cardioprotection with volatile anesthetics: mechanisms and clinical implications.
作者信息
De Hert Stefan G, Turani Franco, Mathur Sanjiv, Stowe David F
机构信息
*Department of Anesthesiology, University Hospital Antwerp, Edegem, Belgium; †Department of Anesthesia and Intensive Care, European Hospital, University of Rome Tor Vergata, Rome, Italy; ‡Department of Anesthesia and Critical Care, Sudbury Regional Hospital, Sudbury, Ontario, Canada; §Departments of Anesthesiology and Physiology, The Medical College of Wisconsin, Department of Biomedical Engineering, Marquette University; Research Service, Veterans Affairs Medical Center, Milwaukee, Wisconsin.
出版信息
Anesth Analg. 2005 Jun;100(6):1584-1593. doi: 10.1213/01.ANE.0000153483.61170.0C.
Cardiac surgery and some noncardiac procedures are associated with a significant risk of perioperative cardiac morbid events. Experimental data indicate that clinical concentrations of volatile general anesthetics protect the myocardium from ischemia and reperfusion injury, as shown by decreased infarct size and a more rapid recovery of contractile function on reperfusion. These anesthetics may also mediate protective effects in other organs, such as the brain and kidney. Recently, a number of reports have indicated that these experimentally observed protective effects may also have clinical implications in cardiac surgery. However, the impact of the use of volatile anesthetics on outcome measures, such as postoperative mortality and recovery in cardiac and noncardiac surgery, is yet to be determined.
心脏手术和一些非心脏手术与围手术期心脏不良事件的重大风险相关。实验数据表明，挥发性全身麻醉药的临床浓度可保护心肌免受缺血再灌注损伤，表现为梗死面积减小以及再灌注时收缩功能更快恢复。这些麻醉药还可能介导对其他器官（如脑和肾）的保护作用。最近，一些报告表明，这些实验观察到的保护作用在心脏手术中可能也具有临床意义。然而，挥发性麻醉药的使用对诸如心脏和非心脏手术的术后死亡率及恢复等结局指标的影响尚待确定。
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