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„Alternative“ Effekte von Lokalanästhetika

“Alternative” effects of local anesthetic agents

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Zusammenfassung

In dem folgenden Artikel werden verschiedene Effekte von Lokalanästhetika beschrieben, die nicht allein durch deren bekannte natriumkanalblockierende Wirkung zu erklären sind. Besonders hervorzuheben ist ihre antiinflammatorische Aktivität, v. a. die Fähigkeit, pathologische Veränderungen, wie exzessive Stimulation des inflammatorischen Systems, zu inhibieren ohne jedoch das körpereigene Abwehrsystem zu schwächen. Im Vergleich zu anderen immunsupprimierenden Medikamenten könnten auch Lokalanästhetika für die Zukunft eine viel versprechende Therapieoption sein. Neben ihrer allgemeinanästhetischen Wirkung scheinen Lokalanästhetika zerebroprotektive Effekte zu haben. Somit könnte ihr Einsatz bei neurochirurgischen Eingriffen von Interesse sein, insbesondere im Hinblick auf ihre kardiovaskuläre Stabilität. Zudem haben Lokalanästhetika die Fähigkeit, die brochiale Hyperreaktivität zu senken, auch wenn die Mechanismen hierzu letztendlich noch nicht im Detail geklärt sind. Die „alternativen“ Effekte der Lokalanästhetika stellen insgesamt eine interessante Perspektive dar, deren Relevanz derzeit jedoch nicht absehbar ist.

Abstract

The following article summarizes different aspects of local anesthetic effects that cannot be explained purely by a sodium channel blockade. Particularly remarkable is hereby their antiinflammatory activity, e.g. the inhibition of pathological changes such as excessive stimulation of the inflammatory system, without compromising the host defense system. In contrast to other immunosuppresive drugs commonly used for treating such conditions, local anesthetics look promising for the future as a new therapeutic option. Besides general anesthetic activity, local anesthetics exert cerebroprotective effects and are furthermore, in consideration of their cardiovascular stability, of interest during neuroanesthetic procedures. In addition, local anesthetics are known for their potency to minimize bronchial hyperreactivity, although details of the underlying mechanisms are not yet elucidated. These effects of local anesthetics may represent interesting prospects for which their relevance has to be determined.

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  1. Universitätsklinik für Anaesthesiologie, Universität Heidelberg

    S. Pecher, B. W. Böttiger, B. Graf &  M. W. Hollmann

  2. Klinik für Anaesthesiologie, Universität Heidelberg, Im Neuenheimer Feld 120, 69115, Heidelberg

    M. W. Hollmann

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  1. S. Pecher
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  2. B. W. Böttiger
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Correspondence to M. W. Hollmann.

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Dr. Hollmann wird unterstützt durch ein Stipendium der Deutschen Forschungsgemeinschaft (DFG HO 2199/1–1), Bonn sowie über den BenCovino Award 2000 und 2002 der Firma AstraZeneca Pain Control, Sweden.

Dr. Pecher und Dr. Hollmann werden unterstützt durch ein Forschungs-Förderungs-Programm der Medizinischen Fakultät Heidelberg.

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Pecher, S., Böttiger, B.W., Graf, B. et al. „Alternative“ Effekte von Lokalanästhetika. Anaesthesist 53, 316–325 (2004). https://doi.org/10.1007/s00101-003-0629-1

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