Rupreht J
Department of Anaesthesiology, Erasmus-University Rotterdam, University-Hospital Dijkzigt, The Netherlands.
Anaesthesiol Reanim. 1991;16(4):250-8.
Clinically relevant aspects of the muscarinic transmission in the CNS are mentioned. This transmission depends on the action of acetylcholine (ACh) on the muscarinic receptor and has been better elucidated than the CNS-cholinergic transmission subserved by the nicotinic receptor. Sub-types of the muscarinic receptor have been demonstrated. They are involved in many functions of the CNS. Therefore, disturbance of the CNS muscarinic transmission by ACh-antagonists or lack of ACh results in a colorful but unpredictable behavioural syndrome which is known as the central anticholinergic syndrome (CAS). To a certain degree, the CAS follows all forms of general anaesthesia. It can be prevented or treated by physostigmine which can elevate ACh-levels in the CNS. Postoperative restitution of the CNS-muscarinic transmission results in appropriate behavioural functioning early recovery. Normalization of ACh in the CNS also enhances analgesia and helps to sustain adequate breathing, heart rate and cardiovascular tone.
文中提到了中枢神经系统中毒蕈碱传递的临床相关方面。这种传递取决于乙酰胆碱（ACh）对毒蕈碱受体的作用，并且比由烟碱受体介导的中枢神经系统胆碱能传递得到了更好的阐释。已证实了毒蕈碱受体的亚型。它们参与中枢神经系统的许多功能。因此，ACh拮抗剂干扰中枢神经系统毒蕈碱传递或ACh缺乏会导致一种丰富多彩但不可预测的行为综合征，即中枢抗胆碱能综合征（CAS）。在一定程度上，CAS会出现在所有形式的全身麻醉之后。它可以通过毒扁豆碱预防或治疗，毒扁豆碱可以提高中枢神经系统中的ACh水平。中枢神经系统毒蕈碱传递的术后恢复可导致行为功能的适当恢复及早期康复。中枢神经系统中ACh的正常化还可增强镇痛作用，并有助于维持适当的呼吸、心率和心血管张力。
