New Inhaled Anesthetics
New Inhaled Anesthetics
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DOI：
10.1097/00004311-199432010-00006
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发表时间：
1994-01
期刊：
影响因子：
8.8
通讯作者：
E. Eger
中科院分区：
文献类型：
--
作者：
E. Eger
地氟烷和七氟烷提供了一个明显优于其他目前可用的强效吸入麻醉剂的优势。它们较低的溶解度允许更精确地控制麻醉剂的输送和更快地从麻醉中恢复。它们的大多数其他属性反映了其前辈的类似属性--只有少数例外。事实上，在1 MAC或更低的浓度下，这两种药物的药理学性质几乎没有差异。然而，与地氟烷相反，在超过1 MAC的浓度下，七氟烷几乎没有或没有呼吸刺激性，可用于快速诱导麻醉。在低于MAC的浓度下，两种麻醉剂似乎都不会对心率产生实质性影响，但在较高浓度下，地氟烷（而非七氟烷）可能会增加心率。地氟烷强烈抵抗碱石灰的生物降解和降解，而七氟烷易降解，碱石灰或钡石灰的降解产生有毒产物。因此，这两种新的麻醉剂都不能说是理想的，但每一种都可能是朝着这个方向迈出的一步。
Desflurane and sevoflurane provide one clear advantage over other currently available potent inhaled anesthetics. Their lower solubilities permit a more precise control over the delivery of anesthesia and a more rapid recovery from anesthesia. Most of their other properties reflect similar properties of their predecessors--with a few exceptions. Indeed, at concentrations of 1 MAC or less, the pharmacologic properties of these two agents differ little if at all. However, in contrast to desflurane, at concentrations exceeding 1 MAC sevoflurane has little or no respiratory irritant properties and may be used to rapidly induce anesthesia. Neither anesthetic seems to materially affect heart rate at concentrations lower than MAC, but at higher concentrations desflurane, but not sevoflurane, may increase heart rate. Desflurane strongly resists biodegradation and degradation by soda lime, whereas sevoflurane is vulnerable to degradation and the degradation by soda lime or Baralyme produces a toxic product. Thus, neither of these new anesthetics can be said to be ideal, but each may be a step in that direction.