D'Athis F
Ann Anesthesiol Fr. 1976;17(4):485-94.
The use of anti-inflammatory corticoids in anesthesia and resuscitation is a long-standing fact, but their indications, owing to the risks to which they expose certain patients and owing to the uncertitude concerning their mechanism of action, are still badly defined. If certain indications (attacks of asthma, laryngeal oedema, certain peri-lesional oedemas) are considered as being categorial, the usefulness of anti-inflammatory corticotherapy is being more and more and more debated in other pathological conditions : infectious or chemical pneumonias, drowning, shocked lung, post-traumatic neuro-surgical conditions, cirrhosis. Very useful in precise indications, anti-inflammatory corticoids should not be prescribed, particularly in fragile patients whom we well know in resuscitation, without having weighed up the advantages and disadvantages related to this remarkable therapeutic instrument.
在麻醉和复苏中使用抗炎皮质激素是一个由来已久的事实,但其适应证由于会使某些患者面临风险且其作用机制尚不确定,目前仍界定不清。如果某些适应证(哮喘发作、喉水肿、某些病变周围水肿)被视为绝对适应证,那么在其他病理状况下(感染性或化学性肺炎、溺水、休克肺、创伤后神经外科疾病、肝硬化),抗炎皮质激素疗法的有效性正受到越来越多的争议。抗炎皮质激素在明确的适应证中非常有用,但在没有权衡与这种显著治疗手段相关的利弊之前,不应开给患者,尤其是我们在复苏中熟知的脆弱患者。