[Inhalational anesthetics].

Inhalationsanästhetika.
Anesthetic gases Desflurane Intraoperative awareness Sevoflurane Volatile anesthetics

Journal

Der Anaesthesist
ISSN: 1432-055X
Titre abrégé: Anaesthesist
Pays: Germany
ID NLM: 0370525

Informations de publication

Date de publication:
04 2021
Historique:
pubmed: 15 1 2021
medline: 25 11 2021
entrez: 14 1 2021
Statut: ppublish

Résumé

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. Inhalationsanästhetika werden seit mehr als 150 Jahren zur Durchführung von Allgemeinanästhesien verwendet. Alle heute verwendeten Substanzen sind chlorierte und fluorierte Ätherderivate. Ihre Dosierung erfolgt nach dem Konzept der „minimal alveolar concentration“ (MAC). Die pharmakokinetischen Eigenschaften der einzelnen Inhalationsanästhetika werden durch spezifische Verteilungskoeffizienten beschrieben. Die Wirkmechanismen umfassen spezifische Modulationen verschiedener Rezeptoren des Zentralnervensystems (ZNS) und eine unspezifische Interaktion an der Zellmembran. Die Organtoxizität heutiger Inhalationsanästhetika wird als minimal erachtet. Die Rolle von Inhalationsanästhetika im Zusammenhang mit „postoperative nausea and vomiting“ (PONV) ist in den letzten Jahren neu bewertet worden. Unbestritten ist die Überlegenheit von Inhalationsanästhetika gegenüber i.v.-Hypnotika bezüglich intraoperativer Awareness. Den organprotektiven Mechanismus der Präkonditionierung bieten unter den heute verfügbaren Narkosemitteln einzig die Inhalationsanästhetika.

Autres résumés

Type: Publisher (ger)
Inhalationsanästhetika werden seit mehr als 150 Jahren zur Durchführung von Allgemeinanästhesien verwendet. Alle heute verwendeten Substanzen sind chlorierte und fluorierte Ätherderivate. Ihre Dosierung erfolgt nach dem Konzept der „minimal alveolar concentration“ (MAC). Die pharmakokinetischen Eigenschaften der einzelnen Inhalationsanästhetika werden durch spezifische Verteilungskoeffizienten beschrieben. Die Wirkmechanismen umfassen spezifische Modulationen verschiedener Rezeptoren des Zentralnervensystems (ZNS) und eine unspezifische Interaktion an der Zellmembran. Die Organtoxizität heutiger Inhalationsanästhetika wird als minimal erachtet. Die Rolle von Inhalationsanästhetika im Zusammenhang mit „postoperative nausea and vomiting“ (PONV) ist in den letzten Jahren neu bewertet worden. Unbestritten ist die Überlegenheit von Inhalationsanästhetika gegenüber i.v.-Hypnotika bezüglich intraoperativer Awareness. Den organprotektiven Mechanismus der Präkonditionierung bieten unter den heute verfügbaren Narkosemitteln einzig die Inhalationsanästhetika.

Identifiants

pubmed: 33443648
doi: 10.1007/s00101-020-00908-1
pii: 10.1007/s00101-020-00908-1
doi:

Substances chimiques

Anesthetics 0
Anesthetics, Inhalation 0
Methyl Ethers 0

Types de publication

Journal Article

Langues

ger

Sous-ensembles de citation

IM

Pagination

343-355

Commentaires et corrections

Type : CommentIn
Type : CommentIn

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Auteurs

Jan Jedlicka (J)

Klinik für Anaesthesiologie, Chirurgische Klinik Nußbaumstraße, LMU Klinikum, Campus Innenstadt, Nußbaumstr. 20, 80336, München, Deutschland. Jan.Jedlicka@med.uni-muenchen.de.

Philipp Groene (P)

Klinik für Anaesthesiologie, Chirurgische Klinik Nußbaumstraße, LMU Klinikum, Campus Innenstadt, Nußbaumstr. 20, 80336, München, Deutschland.

Julia Linhart (J)

Klinik für Anaesthesiologie, Chirurgische Klinik Nußbaumstraße, LMU Klinikum, Campus Innenstadt, Nußbaumstr. 20, 80336, München, Deutschland.

Elisabeth Raith (E)

Klinik für Anaesthesiologie, Chirurgische Klinik Nußbaumstraße, LMU Klinikum, Campus Innenstadt, Nußbaumstr. 20, 80336, München, Deutschland.

Da Vy Mu Stapha (DV)

Klinik für Anaesthesiologie, Chirurgische Klinik Nußbaumstraße, LMU Klinikum, Campus Innenstadt, Nußbaumstr. 20, 80336, München, Deutschland.

Peter Conzen (P)

Klinik für Anaesthesiologie, Chirurgische Klinik Nußbaumstraße, LMU Klinikum, Campus Innenstadt, Nußbaumstr. 20, 80336, München, Deutschland.

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