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麻醉机制:解开麻醉之谜挑战的最新进展。

Anaesthetic mechanisms: update on the challenge of unravelling the mystery of anaesthesia.

作者信息

Kopp Lugli Andrea, Yost Charles Spencer, Kindler Christoph H

机构信息

Department of Anaesthesia, University Hospital Basel, Basel, Switzerland.

出版信息

Eur J Anaesthesiol. 2009 Oct;26(10):807-20. doi: 10.1097/EJA.0b013e32832d6b0f.

Abstract

General anaesthesia is administered each day to thousands of patients worldwide. Although more than 160 years have passed since the first successful public demonstration of anaesthesia, a detailed understanding of the anaesthetic mechanism of action of these drugs is still lacking. An important early observation was the Meyer-Overton correlation, which associated the potency of an anaesthetic with its lipid solubility. This work focuses attention on the lipid membrane as a likely location for anaesthetic action. With the advent of cellular electrophysiology and molecular biology techniques, tools to dissect the components of the lipid membrane have led, in recent years, to the widespread acceptance of proteins, namely receptors and ion channels, as more likely targets for the anaesthetic effect. Yet these accumulated data have not produced a comprehensive explanation for how these drugs produce central nervous system depression. In this review, we follow the story of anaesthesia mechanisms research from its historical roots to the intensely neurophysiological research regarding it today. We will also describe recent findings that identify specific neuroanatomical locations mediating the actions of some anaesthetic agents.

摘要

全球每天都有成千上万的患者接受全身麻醉。尽管自首次成功公开演示麻醉技术以来已经过去了160多年,但对于这些药物的麻醉作用机制仍缺乏详细的了解。一个重要的早期观察结果是迈耶-奥弗顿相关性,它将麻醉剂的效力与其脂溶性联系起来。这项工作将注意力集中在脂质膜上,认为其可能是麻醉作用的部位。随着细胞电生理学和分子生物学技术的出现,近年来用于剖析脂质膜成分的工具使得蛋白质,即受体和离子通道,作为麻醉作用更可能的靶点而被广泛接受。然而,这些积累的数据尚未对这些药物如何产生中枢神经系统抑制作用给出全面的解释。在这篇综述中,我们将追溯麻醉机制研究的历程,从其历史根源到如今关于它的深入神经生理学研究。我们还将描述最近的研究发现,这些发现确定了介导某些麻醉剂作用的特定神经解剖位置。

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