De Hert Stefan G, Preckel Benedikt, Schlack Wolfgang S
Division of Cardiothoracic and Vascular Anaesthesiology, Department of Anaesthesiology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
Curr Opin Anaesthesiol. 2009 Aug;22(4):491-5. doi: 10.1097/ACO.0b013e32832bca38.
Inhalational anaesthetic agents are a cornerstone in modern anaesthetic practice. The currently used compounds are very effective and have a good safety profile. In addition, it has been demonstrated that they possess organ-protective properties that might provide an additional tool in the treatment or prevention of the consequences of organ ischaemia-reperfusion injury or both. The present review summarizes some of the most recent findings on this subject.
The mechanisms underlying the organ-protective effects of inhalational anaesthetics continue to be further unravelled. The main challenge, however, is to determine the clinical importance of these protective effects and their potential benefits for patients. Initial observations in cardiac surgery are encouraging, and the first clinical studies on other organ systems are being published. Noble gases share these organ-protective properties and may provide an additional tool for this purpose both in situations in which anaesthesia is needed (xenon) or in cases in which anaesthesia is not necessary (helium).
In the experimental setting, inhalational anaesthetics have protective effects against ischaemia-reperfusion injury. Initial perioperative data suggest that these effects may also result into clinically relevant improved organ function. However, further research will be needed to reveal whether these organ-protective properties will ultimately translate into an improved short-term and long-term postoperative outcome.
吸入麻醉剂是现代麻醉实践的基石。目前使用的化合物非常有效且安全性良好。此外，已经证明它们具有器官保护特性，这可能为治疗或预防器官缺血再灌注损伤的后果或两者提供额外的手段。本综述总结了关于该主题的一些最新发现。
吸入麻醉剂器官保护作用的潜在机制仍在进一步探索中。然而，主要挑战在于确定这些保护作用的临床重要性及其对患者的潜在益处。心脏手术中的初步观察结果令人鼓舞，关于其他器官系统的首批临床研究也正在发表。惰性气体也具有这些器官保护特性，并且在需要麻醉的情况（氙气）或不需要麻醉的情况（氦气）下都可能为此提供额外的手段。
在实验环境中，吸入麻醉剂对缺血再灌注损伤具有保护作用。围手术期的初步数据表明，这些作用也可能导致临床上相关器官功能的改善。然而，需要进一步研究以揭示这些器官保护特性最终是否会转化为术后短期和长期结果的改善。
