摘要
全麻复苏是全身麻醉的重要组成部分,随着神经科学在麻醉领域的深入研究,全麻复苏并非药物代谢的被动过程,其涉及脑内众多功能神经网络的主动活化和相继激活,最终促进意识恢复。然而,苏醒延迟、术后谵妄以及躁动的发生机制依旧不明,而解决此类问题的关键是充分理解全麻复苏的神经网络动态演变过程。本文结合新近研究,综述基底前脑、下丘脑、中脑腹侧被盖区、蓝斑核、乳头结节、臂旁核、中缝背核以及各核团所分泌的主要神经递质在复苏中的网络作用机制,为临床开展意识研究提供理论基础,同时为深入研究苏醒延迟、术后认知功能障碍等问题提供新思路。
General anesthesia resuscitation is an important part of general anesthesia.With the discovery of neuroscience in the field of anesthesia,studies have shown that emergence from general anesthesia is not a passive process of drug metabolism.It involves the sequential activation of many functional neural networks in the brain,and finally promotes the recovery of consciousness.However,the mechanisms of delayed emergence from anesthesia,postoperative delirium and agitation are still unclear,and the key to solving such problems is to fully understand the dynamic evolution of neural networks in general anesthesia and resuscitation.Combined with the recent research progress,this paper summarizes the mechanism of the basal forebrain,hypothalamus,ventral tegmental area,locus coeruleus,tuberomammillary nucleus,parabrachial nuclei,dorsal raphe nucleus,and the main neurotransmitters secreted by these nucleus in resuscitation.The mechanism of functional neural networks will deserve further study,which will support a theoretical basis for clinical consciousness research,and provide new ideas for dealing with problems such as delayed emergence and postoperative cognitive dysfunction.
作者
冯振鑫
赵亮
蔡伟华
邢飞
张卫
FENG Zhenxin;ZHAO Liang;CAI Weihua;XING Fei;ZHANG Wei(Department of Anesthesiology,Shenzhen Stomatology Hos-pital(Pingshan)of Southern Medical University,Shenzhen 518000,China)
出处
《临床麻醉学杂志》
CAS
CSCD
北大核心
2022年第12期1317-1321,共5页
Journal of Clinical Anesthesiology
关键词
全身麻醉
神经网络
麻醉复苏
苏醒延迟
意识
General anesthesia
Neural networks
Anesthetic emergence
Delayed emergence
Consciousness
