Jedlicka Jan, Groene Philipp, Linhart Julia, Raith Elisabeth, Mu Stapha Da Vy, Conzen Peter
Klinik für Anaesthesiologie, Chirurgische Klinik Nußbaumstraße, LMU Klinikum, Campus Innenstadt, Nußbaumstr. 20, 80336, München, Deutschland.
Anaesthesist. 2021 Apr;70(4):343-355. doi: 10.1007/s00101-020-00908-1.
Inhalational anesthetics have been used for induction and maintenance of general anesthesia for more than 150 years. All of the currently used inhalational anesthetics are chlorinated and fluorinated derivatives of ether. Dosing is carried out using the minimal alveolar concentration (MAC) concept. The pharmacokinetic properties of the various inhalational anesthetics are governed by the specific distribution coefficients. Mechanisms of action include specific modulations of various receptors of the central nervous system as well as an unspecific interaction with the cell membrane. Organ toxicity of modern inhalational anesthetics is considered to be minimal. The role of inhalational anesthetics in the context of postoperative nausea and vomiting (PONV) has been reassessed in recent years. The superiority of inhalational anesthetics over intravenous hypnotics with respect to intraoperative awareness is undisputed. The organ protective mechanism of preconditioning is an exclusive property of inhalational anesthetics among all the currently available hypnotics.
吸入性麻醉剂用于全身麻醉的诱导和维持已有150多年的历史。目前所有使用的吸入性麻醉剂都是醚的氯化和氟化衍生物。给药是根据最低肺泡浓度(MAC)概念进行的。各种吸入性麻醉剂的药代动力学特性由特定的分配系数决定。作用机制包括对中枢神经系统各种受体的特定调节以及与细胞膜的非特异性相互作用。现代吸入性麻醉剂的器官毒性被认为是最小的。近年来,吸入性麻醉剂在术后恶心呕吐(PONV)方面的作用已被重新评估。在术中知晓方面,吸入性麻醉剂优于静脉催眠药,这一点无可争议。预处理的器官保护机制是目前所有可用催眠药中吸入性麻醉剂独有的特性。