Deile M, Damm M, Heller A R
Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
Anaesthesist. 2013 Jun;62(6):493-504. doi: 10.1007/s00101-013-2175-9.
Inhaled anesthetics are inhaled via the lungs. They subsequently pass through the alveolocapillary membrane and diffuse into the blood to finally target the central nervous system and induce anesthesia. This principle of anesthesia induction was first described for diethylether in 1847. Nevertheless, the use of diethylether for anesthesia is obsolete and even the use of nitrous oxide (introduced for anesthesia in 1847) is declining in Germany. Almost all modern volatile anesthetics are halogenated methylethylethers in which fluorine is used as a halogen. All of these anesthetics depress myocardial contractility and induce hypotension. Depression of CO2 and hypoxia-induced respiration are other serious side effects. Further side effects are liver and kidney related but they are rare and not induced by anesthetics per se but preferentially by toxic metobolites. Another promising inhalative anesthetic is xenon which fulfils many aspects of an ideal inhalative anesthetic.
吸入性麻醉剂通过肺部吸入。随后,它们穿过肺泡毛细血管膜并扩散到血液中,最终作用于中枢神经系统并诱导麻醉。这种麻醉诱导原理最早于1847年针对乙醚进行了描述。然而,乙醚用于麻醉已过时,甚至在德国,一氧化二氮(1847年引入用于麻醉)的使用也在减少。几乎所有现代挥发性麻醉剂都是卤化甲基乙基醚,其中氟用作卤素。所有这些麻醉剂都会抑制心肌收缩力并导致低血压。抑制二氧化碳和缺氧诱导的呼吸是其他严重的副作用。进一步的副作用与肝脏和肾脏有关,但很少见,并非由麻醉剂本身引起,而是主要由有毒代谢产物引起。另一种有前景的吸入性麻醉剂是氙气,它满足了理想吸入性麻醉剂的许多方面。