Piegeler T, Werdehausen R
Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Leipzig (AöR), Liebigstraße 20, 04103, Leipzig, Deutschland.
Anaesthesist. 2018 Jul;67(7):525-528. doi: 10.1007/s00101-018-0453-2.
Besides the well-known analgesic effects of amide-linked local anesthetics exerted via the inhibition of the voltage-gated sodium channel, these substances also possess a certain number of properties, which bear the potential to positively influence the outcome after surgery. The results of several experimental as well as clinical studies suggest the possibility of an enhanced recovery after surgery, reduction in the incidence of chronic pain, preservation of endothelial barrier function during acute lung injury and the prevention of metastasis of solid tumors by systemic effects of local anesthetic administration. Mechanistic studies were able to identify several "new targets", such as the inhibition of spinal glycine transporters or of inflammatory signaling as induced by tumor necrosis factor alpha. Further elucidation of these mechanistic pathways as well as the translation of these promising experimental results into clinical practice is a crucial component of research activities in the field of anesthesia.
除了酰胺类局部麻醉药通过抑制电压门控钠通道产生的众所周知的镇痛作用外，这些物质还具有一定数量的特性，有可能对手术后的结果产生积极影响。多项实验和临床研究结果表明，局部麻醉药全身给药可能具有促进术后恢复、降低慢性疼痛发生率、在急性肺损伤期间维持内皮屏障功能以及预防实体瘤转移的作用。机制研究已经确定了几个“新靶点”，如抑制脊髓甘氨酸转运体或肿瘤坏死因子α诱导的炎症信号。进一步阐明这些机制途径以及将这些有前景的实验结果转化为临床实践是麻醉领域研究活动的关键组成部分。
