Arnaud A, Gayrard P, Ohresser P
Ann Anesthesiol Fr. 1976;17(2):139-44.
The comprehension of the occurrence of bronchospasm during surgery is based on the knowledge of the factors which control bronchomotility: parasympathetic or cholinergic system, essentially bronchoconstrictor; sympathetic adrenergic system, with beta-2 effect, bronchodilator, and with alpha-bronchoconstrictor effect. It is also worth bearing in mind the chemical midiators, in particular, histamine contained in the mast cells, "slow reacting substance of anaphylaxis" which is a bronchoconstrictor substance of slow and prolonged action, Serotonin whose role is more modest. The last mediators known, prostaglandins, play an important role in the regulation of bronchomotility, PGE' are bronchodilators, PGF 2 alpha are bronchoconstrictors. With reference to the development of bronchospasm during anesthesia, one must bear in mind the background, and in particular of the allergy, of a past history of asthma and of the pre-operative functional respiratory condition. One must also bear in mind the anaesthesia, and the pharmacodynamic action of the substances used which can interfere with the phenomena controlling bronchomotor tone.
副交感神经或胆碱能系统,主要起支气管收缩作用;交感肾上腺素能系统,具有β-2效应,起支气管扩张作用,以及具有α-支气管收缩效应。还值得注意的是化学介质,特别是肥大细胞中所含的组胺、“过敏反应迟缓物质”(一种作用缓慢且持久的支气管收缩物质)、作用相对较小的血清素。最后已知的介质前列腺素在支气管运动性调节中起重要作用,前列腺素E起支气管扩张作用,前列腺素F 2α起支气管收缩作用。关于麻醉期间支气管痉挛的发生,必须考虑患者的背景情况,尤其是过敏史、既往哮喘病史以及术前呼吸功能状况。还必须考虑麻醉以及所用药物的药效学作用,这些可能会干扰控制支气管运动张力的现象。