Zusammenfassung
Als inhalative Anästhetika werden Narkotika bezeichnet, die im gasförmigen Zustand über die Lungen inhaliert und anschließend im Blut gelöst an ihren Wirkort transportiert werden. Diese Form der Anästhesie wurde bereits 1847, als Äthernarkose, erfolgreich demonstriert. Äthernarkosen sind heutzutage obsolet, und auch der Gebrauch von Lachgas ist in Deutschland rückläufig. Chemisch sind die meisten modernen Inhalationsanästhetika halogenierte Äthylmethyläther. Als Halogen dient dabei Fluor. Unerwünschte Arzneimittelwirkungen bestehen in der Verminderung der myokardialen Kontraktilität und des arteriellen Blutdrucks sowie der Herabsetzung des CO2- und hypoxieinduzierten Atemantriebs. Weitere Nebenwirkungen betreffen Lungen und Leber, sind aber selten und werden nicht durch diese Anästhetika selbst, sondern vielmehr durch toxische Metaboliten ausgelöst. Ein vielversprechendes Narkosemittel ist das Edelgas Xenon, da es viele der Anforderungen an ein ideales Narkosegas erfüllt.
Abstract
Inhaled anesthetics are inhaled via the lungs. They subsequently pass through the alveolocapillary membrane and diffuse into the blood to finally target the central nervous system and induce anesthesia. This principle of anesthesia induction was first described for diethylether in 1847. Nevertheless, the use of diethylether for anesthesia is obsolete and even the use of nitrous oxide (introduced for anesthesia in 1847) is declining in Germany. Almost all modern volatile anesthetics are halogenated methylethylethers in which fluorine is used as a halogen. All of these anesthetics depress myocardial contractility and induce hypotension. Depression of CO2 and hypoxia-induced respiration are other serious side effects. Further side effects are liver and kidney related but they are rare and not induced by anesthetics per se but preferentially by toxic metobolites. Another promising inhalative anesthetic is xenon which fulfils many aspects of an ideal inhalative anesthetic.
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Deile, M., Damm, M. & Heller, A. Inhalative Anästhetika. Anaesthesist 62, 493–504 (2013). https://doi.org/10.1007/s00101-013-2175-9
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DOI: https://doi.org/10.1007/s00101-013-2175-9