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静脉麻醉药在神经方面的作用:保护还是毒性?

The Role of Intravenous Anesthetics for Neuro: Protection or Toxicity?

作者信息

Wang Kaixin, Wang Yafeng, Zhang Tianhao, Chang Bingcheng, Fu Daan, Chen Xiangdong

机构信息

Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

Institute of Anesthesia and Critical Care Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.

出版信息

Neurosci Bull. 2025 Jan;41(1):107-130. doi: 10.1007/s12264-024-01265-4. Epub 2024 Aug 17.

Abstract

The primary intravenous anesthetics employed in clinical practice encompass dexmedetomidine (Dex), propofol, ketamine, etomidate, midazolam, and remimazolam. Apart from their established sedative, analgesic, and anxiolytic properties, an increasing body of research has uncovered neuroprotective effects of intravenous anesthetics in various animal and cellular models, as well as in clinical studies. However, there also exists conflicting evidence pointing to the potential neurotoxic effects of these intravenous anesthetics. The role of intravenous anesthetics for neuro on both sides of protection or toxicity has been rarely summarized. Considering the mentioned above, this work aims to offer a comprehensive understanding of the underlying mechanisms involved both in the central nerve system (CNS) and the peripheral nerve system (PNS) and provide valuable insights into the potential safety and risk associated with the clinical use of intravenous anesthetics.

摘要

临床实践中使用的主要静脉麻醉药包括右美托咪定(Dex)、丙泊酚、氯胺酮、依托咪酯、咪达唑仑和瑞马唑仑。除了其既定的镇静、镇痛和抗焦虑特性外,越来越多的研究在各种动物和细胞模型以及临床研究中发现了静脉麻醉药的神经保护作用。然而,也有相互矛盾的证据表明这些静脉麻醉药具有潜在的神经毒性作用。静脉麻醉药在神经保护或毒性两方面的作用很少被总结。考虑到上述情况,这项工作旨在全面了解中枢神经系统(CNS)和外周神经系统(PNS)中涉及的潜在机制,并为静脉麻醉药临床使用相关的潜在安全性和风险提供有价值的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b813/11748649/42b83d757dfb/12264_2024_1265_Fig1_HTML.jpg

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