Campesi Ilaria, Fois Marco, Franconi Flavia
Department of Biomedical Sciences, University of Sassari, Sassari, Italy.
Handb Exp Pharmacol. 2012(214):265-78. doi: 10.1007/978-3-642-30726-3_13.
The influence of sex and gender on anesthesia and analgesic therapy remains poorly understood, nevertheless the numerous physiological and pharmacological differences present between men and women. Although in anesthesiology sex-gender aspects have attracted little attention, it has been reported that women have a greater sensitivity to the non-depolarizing neuroblocking agents, whereas males are more sensitive than females to propofol. It has been suggested that men wake slower than women after general anesthesia and have less postoperative nausea and vomiting. Sexual hormones seem to be of importance in the onset of differences. Nevertheless, in the last years, sex-gender influences on pain and analgesia have become a hot topic and data regarding sex-gender differences in response to pharmacologic and non-pharmacologic pain treatments are still scanty, inconsistent, and non-univocal. In particular, females seem to be more sensitive than males to opioid receptor agonists. Women may experience respiratory depression and other adverse effects more easily if they are given the same doses as males. Evidently, there is an obvious need for more research, which should include psychological and social factors in experimental preclinical and clinical paradigms in view of their importance on pain mechanism, in order to individualize analgesia to optimize pain relief.
性别对麻醉和镇痛治疗的影响仍未得到充分理解，尽管男性和女性之间存在众多生理和药理学差异。虽然在麻醉学中，性别方面的问题很少受到关注，但据报道，女性对非去极化神经阻滞剂更为敏感，而男性对丙泊酚的敏感性高于女性。有人认为，全身麻醉后男性比女性苏醒得慢，术后恶心和呕吐也较少。性激素似乎在这些差异的产生中起重要作用。然而，近年来，性别对疼痛和镇痛的影响已成为一个热门话题，关于性别在药物和非药物疼痛治疗反应方面差异的数据仍然稀少、不一致且不明确。特别是，女性似乎比男性对阿片受体激动剂更敏感。如果给予与男性相同的剂量，女性可能更容易出现呼吸抑制和其他不良反应。显然，迫切需要进行更多研究，鉴于心理和社会因素对疼痛机制的重要性，在临床前和临床实验范式中应将其纳入考虑，以便实现镇痛个体化，优化疼痛缓解效果。
