七氟烷对发育中大脑是保护还是损害  

Sevoflurane：harm or protection to a developing brain

作　　者：薛荣亮[1] 镇路明[1] 

机构地区：[1]西安交通大学医学院第二附属医院麻醉科,710004

出　　处：《国际麻醉学与复苏杂志》2013年第9期827-829,833,共4页International Journal of Anesthesiology and Resuscitation

摘　　要：背景七氟烷是一种优良的新型吸人麻醉剂，具有血，气分配系数低，麻醉诱导时间短，麻醉深度易于控制，清醒速度快，肝肾功能影响小，血流动力学稳定等特点。而其所具有的芳香味，使七氟烷在小儿麻醉中更具优势。了解七氟烷对发育中大脑的影响可使麻醉医师在临床应用时扬长避短。目的对以往文献进行回顾并综合目前最新研究进展，深入分析七氟烷对发育中大脑的影响。内容已有大量关于七氟烷对发育中大脑影响的研究，由于临床试验的局限性，大部分研究都在动物模型上实施，七氟烷对发育中大脑是具有保护作用抑或是损害，其机制是什么，不同的研究者试验结论不一致甚至相悖。趋势目前关于吸入麻醉药的麻醉作用机制和神经保护、神经毒性作用机制已经深入到分子水平。由于大脑内存在多种信号通路、离子通道以及神经递质，使得七氟烷对大脑影响的机制变得复杂，进行更深入的研究迫在眉睫。Background Plenty of studies have indicated that sevoflurane is a new inhalation anesthetic with more satisfying properties： low blood partition coefficient that allows rapid induction, easy-controlled depth, fewer side effects to liver and kidney as well as stability of hemodynamics. Especially its aromatic flavor makes sevoflurane more widely used in pediatric anesthesia. The knowledge of the effect of sevoflurane on the developing brain can make it more useful with the least harm. Objective We reviewed previous literature and integrated the latest research progress to deeply analyze and summarize the effects of sevoflurane on the developing brain. Content Researches of the effect of sevoflurane on the developing brain have amassed. Due to the limitations of clinical trials, most of the studies were carried out in experimental animals. Whether sevoflurane is neuroprotective or neurotoxic on the developing brain is still controversial, let alone of the complicated molecular mechanism. Trend The exact way that whether sevoflurane affords protection or toxicity has penetrated into molecular mechanism. Diversity of pleiotropic intracellular signaling, ligand-gated ion channels and release of neurotransmitters increases the complexity of the present issue. Therefore, further researches are urgent.

关 键 词：七氟烷 大脑 神经毒性 神经保护 

分 类 号：R614[医药卫生—麻醉学]