摘要
背景依托咪酯作为一种静脉麻醉药，由于其苏醒迅速、血流动力学稳定、对呼吸影响小、具有脑保护作用等特点，已被大量应用于临床麻醉。但其对内分泌系统的影响，尤其是对肾上腺皮质功能的抑制作用，影响了麻醉医师临床应用的热情。近年由于少有关于依托咪酯诱导或短时间输注引起的具有临床意义的肾上腺皮质抑制的新报道，其应用又有逐渐增加的趋势。目的通过总结国内外的研究，探讨依托咪酯用于全身麻醉诱导、维持及危重患者的可行性，了解针对减轻其肾上腺毒性的新的研究方向与实验设计。内容对依托咪酯肾上腺毒性的药理机制、临床应用进行综述。趋向随着对依托咪酯肾上腺毒性作用的深入研究，其用于非危重患者的全身麻醉诱导与维持已得到认可，而用于危重患者仍具有较大争议。小剂量药物预处理减轻其。肾上腺毒性以及改变分子结构的新方法已成为研究减轻依托咪酯肾上腺毒性的热点和新方向。
Background Etomidate was widely used for general anesthesia before due to its fast recovery from unconsciousness, stable hemodynamics, little respiratory depression, and cerebral protection, etc. The side effects of etomidate on endocrine system, especially the inhibition on adrenal cortex impacted its clinical use. However, recent studies show that etomidate does not cause significant suppression of adrenal cortex when it is used for anesthesia induction or short time maintenance by intravenous infusion. Objective To summarize the recent researches about the feasibility of etomidate for anesthesia induction and maintenance in critical patients and the new research directions and experimental designs of reducing adrenal cortex suppression caused by etomidate. Content The mechanisms of adrenal cortex suppression caused by etomidate and its clinical application were reviewed. Trend Along with the in-depth study of adrenal cortex suppression caused by etomidate, it is well recognized that etomidate can be safely used for anesthesia induction and maintenance in non-critically ill patients, but its clinical use in critically ill patients is still under disputation. Small dose of drug pretreatments and modifications of molecular structure to reduce adrenal cortex suppression caused by etomidate will become to be new research directions.
出处
《国际麻醉学与复苏杂志》
CAS
2015年第6期531-535,共5页
International Journal of Anesthesiology and Resuscitation
关键词
依托咪酯
麻醉
全身
肾上腺皮质功能
Etomidate
Anesthesia, general
Adrenocortical function
