Feyh L S
CRNA. 1993 Nov;4(4):161-9.
The most common local anesthetics in clinical use today are of two classes: amino-esters and amino-amides. These two classes differ not only in their chemical structure but also in regard to their metabolism and allergic potential. Potency, onset of action, duration of action, and relative blockade of sensory and motor fibers are important clinical properties of local anesthetics. These clinical properties are related to the physiochemical properties of lipid solubility, pKa, and protein binding. The effects of local anesthetics are primarily caused by the blockade of the sodium channels, thus affecting the slow and fast depolarization phase of the action potential. With the basic understanding of the chemistry and pharmacology of the different local anesthetic agents, the nurse anesthetist can more effectively integrate the use of these drugs into their clinical practice.
氨基酯类和氨基酰胺类。这两类药物不仅化学结构不同，而且在代谢和过敏可能性方面也存在差异。效能、起效时间、作用持续时间以及对感觉和运动纤维的相对阻滞是局部麻醉药的重要临床特性。这些临床特性与脂溶性、pKa和蛋白质结合等物理化学性质有关。局部麻醉药的作用主要是通过阻断钠通道引起的，从而影响动作电位的缓慢和快速去极化阶段。在对不同局部麻醉药的化学和药理学有了基本了解之后，麻醉护士可以更有效地将这些药物的使用融入到他们的临床实践中。
