Regional anaesthesia, local anaesthetics and the surgical stress response.
Regional anaesthesia, local anaesthetics and the surgical stress response.
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DOI：
10.1016/j.bpa.2004.01.004
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发表时间：
2004-09-01
期刊：
影响因子：
--
通讯作者：
Hollmann, Markus W
中科院分区：
文献类型：
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作者：
Hahnenkamp, Klaus;Herroeder, Susanne;Hollmann, Markus W
硬膜外麻醉有可能通过减少术后发病率和恢复时间来改善患者在大手术后的预后。可能的益处包括心脏并发症的减轻、与患者总体舒适度增加相关的胃肠道功能的早期恢复、肺功能障碍的发生率降低、对凝血系统的有益作用以及炎症反应的减少。然而，其内在机制仍不清楚。由于局部麻醉剂（LAs），从硬膜外腔重吸收，似乎有助于这些影响，这是不容易区分的全身作用的LAs和硬膜外麻醉的神经轴阻滞的影响。因此，在不能或不愿意接受术中和/或术后硬膜外镇痛的患者中，LA的全身给药可被认为是一种新的治疗方法，通过调节术中和术后炎症来预防术后疾病。
Epidural anaesthesia has the potential to improve patients' outcome after major surgical procedures by reducing postoperative morbidity and duration of recovery. Possible benefits include the attenuation of cardiac complications, an earlier return of gastrointestinal function associated with an increase in patients' comfort overall, decreased incidence of pulmonary dysfunction, beneficial effects on the coagulation system and a reduction in the inflammatory response. The underlying mechanisms, however, remain unclear. Since local anaesthetics (LAs), reabsorbed from the epidural space, seem to contribute to these effects, it is not easy to differentiate between the systemic effects of LAs and the effects of neuraxial blockade by epidural anaesthesia. Thus, in patients not able or willing to receive intra- and/or postoperative epidural analgesia, systemic administration of LAs may be considered to be a new therapeutic approach for the prevention of postoperative disorders by modulation of the peri- and postoperative inflammatory.