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[静脉诱导麻醉药物:巴比妥类药物]

[Drugs for intravenous induction of anesthesia: barbiturates].

作者信息

Dumps C, Halbeck E, Bolkenius D

机构信息

Klinik für Anästhesiologie und Operative Intensivmedizin, Klinikum Augsburg, Stenglinstr. 2, 86156, Augsburg, Deutschland.

出版信息

Anaesthesist. 2018 Jul;67(7):535-552. doi: 10.1007/s00101-018-0440-7.

Abstract

The discovery of barbituric acid and research on its derivatives have long been of importance in advancements in modern anesthesia. Decades of clinical use of barbiturates worldwide and their abuse has led to an enormous amount of knowledge. Thiopental and methohexital are ultra-short acting derivatives of barbiturates. Their clinical application has been accompanied by an enormous increase in the knowledge of the pharmacology of cerebrally active drugs, in particular gamma-aminobutyric acid (GABA) receptor and GABA-induced effects on nerve cell membranes. Despite the development of newer substances, thiopental still has a firm place in clinical applications. Currently it is mainly used in obstetrics for induction of cesarean sections under general anesthesia. A disadvantage, when properly used to induce anesthesia, is usually only the prolonged elimination kinetics of barbiturates. It is beneficial that barbiturates do not require side effect provoking solubilizers.

摘要

巴比妥酸的发现及其衍生物的研究长期以来对现代麻醉学的发展具有重要意义。全球范围内数十年的巴比妥类药物临床应用及其滥用带来了大量知识。硫喷妥钠和甲己炔巴比妥是巴比妥类药物的超短效衍生物。它们的临床应用伴随着对脑活性药物药理学知识的大幅增加,尤其是γ-氨基丁酸(GABA)受体以及GABA对神经细胞膜的诱导作用。尽管有更新的药物问世,但硫喷妥钠在临床应用中仍占有稳固地位。目前它主要用于产科全身麻醉下剖宫产的诱导。当正确用于诱导麻醉时,其一个缺点通常只是巴比妥类药物消除动力学的延长。巴比妥类药物不需要引起副作用的增溶剂,这是有益的。

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