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氯胺酮镇痛的基础和临床科学研究进展。

An Update on the Basic and Clinical Science of Ketamine Analgesia.

机构信息

Departments of Anesthesiology, Perioperative Care and Pain Medicine.

Neuroscience and Physiology, New York University School of Medicine, New York, NY.

出版信息

Clin J Pain. 2018 Nov;34(11):1077-1088. doi: 10.1097/AJP.0000000000000635.

Abstract

OBJECTIVE

In the context of the current opioid epidemic, there has been a renewed interest in the use of ketamine as an analgesic agent.

METHODS

We reviewed ketamine analgesia.

RESULTS

Ketamine is well-known as an antagonist for N-methyl-D-aspartate receptors. In addition, it can regulate the function of opioid receptors and sodium channels. Ketamine also increases signaling through α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors. These myriad of molecular and cellular mechanisms are responsible for a number of pharmacological functions including pain relief and mood regulation. Clinically, a number of studies have investigated the role of ketamine in the setting of acute and chronic pain, and there is evidence that ketamine can provide analgesia in a variety of pain syndromes.

DISCUSSION

In this review, we examined basic mechanisms of ketamine and its current clinical use and potential novel use in pain management.

摘要

目的

在当前阿片类药物流行的背景下,人们对氯胺酮作为一种镇痛剂的应用重新产生了兴趣。

方法

我们回顾了氯胺酮的镇痛作用。

结果

氯胺酮作为 N-甲基-D-天冬氨酸受体拮抗剂广为人知。此外,它还可以调节阿片受体和钠离子通道的功能。氯胺酮还可以增加α-氨基-3-羟基-5-甲基-4-异恶唑丙酸受体的信号传递。这些众多的分子和细胞机制负责许多药理学功能,包括缓解疼痛和调节情绪。临床上,许多研究已经调查了氯胺酮在急性和慢性疼痛中的作用,有证据表明氯胺酮可以在多种疼痛综合征中提供镇痛作用。

讨论

在这篇综述中,我们检查了氯胺酮的基本机制及其目前在疼痛管理中的临床应用和潜在的新用途。

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