Chronobiology and anaesthesia
Chronobiology and anaesthesia
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DOI：
10.1097/aco.0b013e328136c55e
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发表时间：
2007-06-01
影响因子：
2.5
通讯作者：
Boselli, Emmanuel
中科院分区：
文献类型：
--
作者：
Chassard, Dominique;Duflo, Frederic;Boselli, Emmanuel
综述目的已经表明，生物节律影响麻醉剂（例如局部麻醉剂、催眠剂和肌肉松弛剂）的药理学和效果。这篇综述讨论了最新的发现及其对麻醉实践的影响。最近的发现阿片类药物和新型局部麻醉剂在注射到脊柱或硬膜外腔用于分娩镇痛时表现出昼夜节律变化。其他研究表明，异丙酚和氯胺酮在动物休息期间（人类夜间）注射时具有最长的作用持续时间。研究还表明，异丙酚可以扰乱中央昼夜节律起搏器，从而导致对大鼠活动的影响发生相移提前。 总结 尽管对人类使用的大多数新型麻醉剂缺乏研究，但最近的研究结果再次强调，在麻醉药物的研究中应考虑时间生物学。在药代动力学和药效学分析中应考虑昼夜节律，以便设计适当的研究方案。时间生物学对临床麻醉实践的影响可能不太重要，因为使用患者控制的设备进行疼痛管理、肌肉麻痹监测和麻醉深度监测。
Purpose of reviewIt has been shown that biological rhythms influence the pharmacology and effects of anaesthetic agents such as local anaesthetics, hypnotics and muscle relaxants. This review discusses the latest findings and their consequences for anaesthesiological practice.Recents findingsOpioids and new local anaesthetics exhibit circadian changes when they are injected into spinal or epidural spaces for labour pain analgesia. Other studies have demonstrated that propofol and ketamine have maximal duration of action when they are injected during a period of rest in animals (at night in humans). It has been also shown that propofol can perturb the central circadian pacemaker and so cause a phase-shifted advance in effect on activity in rats.SummaryAlthough studies are lacking for most newer anaesthetic agents used in humans, recent findings emphasize once again that chronobiology should be considered in studies of anaesthetic drugs. Circadian rhythms should be considered in pharmacokinetic and pharmacodynamic analyses so that proper research protocols can be designed. The implications of chronobiology for the practice of clinical anaesthesia are probably of lesser importance because of the use of patient-controlled devices for pain management, monitoring of muscle paralysis and depth of anaesthesia monitors.