Hypnotika in der Anästhesiologie: Barbiturate, Propofol, Etomidat

Living reference work entry
Part of the Springer Reference Medizin book series (SRM)

Zusammenfassung

Hypnotika werden sowohl zur Narkoseeinleitung und -aufrechterhaltung im Rahmen einer totalen intravenösen Anästhesie (TIVA) als auch zur Sedierung auf Intensivstationen eingesetzt. Entsprechend hoch ist ihr Stellenwert in der Anästhesie. Das Kapitel gibt einen Überblick über den grundsätzlichen Wirkmechanismus der Hypnotika sowie die Pharmakokinetik, Pharmakodynamik und die klinischen Anwendungsgebiete der einzelnen Hypnotika.

Literatur

  1. 1.
    Franks NP, Lieb WR (1997) Inhibitory synapses. Anaesthetics set their sites on ion channels. Nature 389:334–335CrossRefPubMedGoogle Scholar
  2. 2.
    Brown EN, Lydic R, Schiff ND (2010) General anesthesia, sleep, and coma. N Engl J Med 363:2638–2650CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Price HL (1960) A dynamic concept of the distribution of thiopental in the human body. Anesthesiology 21:40–45CrossRefPubMedGoogle Scholar
  4. 4.
    Hudson RJ, Stanski DR, Burch PG (1983) Pharmacokinetics of methohexital and thiopental in surgical patients. Anesthesiology 59:215–219CrossRefPubMedGoogle Scholar
  5. 5.
    Hempel V (1994) 60 years thiopental. Anästhesiol Intensivmed Notfallmed Schmerzther: AINS 29:400–407Google Scholar
  6. 6.
    Van Hamme MJ, Ghoneim MM, Ambre JJ (1978) Pharmacokinetics of etomidate, a new intravenous anesthetic. Anesthesiology 49:274–277CrossRefPubMedGoogle Scholar
  7. 7.
    Vanlersberghe C, Camu F (2008) Etomidate and other non-barbiturates. Handb Exp Pharmacol 182:267–282CrossRefGoogle Scholar
  8. 8.
    Roberts I (2000) Barbiturates for acute traumatic brain injury. Cochrane Database Syst Rev (12):CD000033Google Scholar
  9. 9.
    Eames WO, Rooke GA, Wu RS, Bishop MJ (1996) Comparison of the effects of etomidate, propofol, and thiopental on respiratory resistance after tracheal intubation. Anesthesiology 84:1307–1311CrossRefPubMedGoogle Scholar
  10. 10.
    Avram MJ, Sanghvi R, Henthorn TK et al (1993) Determinants of thiopental induction dose requirements. Anesth Analg 76:10–17CrossRefPubMedGoogle Scholar
  11. 11.
    Masui K, Upton RN, Doufas AG et al (2010) The performance of compartmental and physiologically based recirculatory pharmacokinetic models for propofol: a comparison using bolus, continuous, and target-controlled infusion data. Anesth Analg 111:368–379CrossRefPubMedGoogle Scholar
  12. 12.
    Eleveld DJ et al (2014) A general purpose pharmacokinetic model for propofol. Anesth Analg 118(6):1221–1237. doi:10.1213/ANE.0000000000000165Google Scholar
  13. 13.
    Smith I, White PF, Nathanson M, Gouldson R (1994) Propofol. An update on its clinical use. Anesthesiology 81:1005–1043CrossRefPubMedGoogle Scholar
  14. 14.
    Hoymork SC, Raeder J (2005) Why do women wake up faster than men from propofol anaesthesia? Br J Anaesth 95:627–633CrossRefPubMedGoogle Scholar
  15. 15.
    Hiraoka H, Yamamoto K, Miyoshi S et al (2005) Kidneys contribute to the extrahepatic clearance of propofol in humans, but not lungs and brain. Br J Clin Pharmacol 60:176–182CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Takizawa D, Hiraoka H, Goto F et al (2005) Human kidneys play an important role in the elimination of propofol. Anesthesiology 102:327–330CrossRefPubMedGoogle Scholar
  17. 17.
    He YL, Ueyama H, Tashiro C et al (2000) Pulmonary disposition of propofol in surgical patients. Anesthesiology 93:986–991CrossRefPubMedGoogle Scholar
  18. 18.
    Apfel CC, Korttila K, Abdalla M et al (2004) A factorial trial of six interventions for the prevention of postoperative nausea and vomiting. N Engl J Med 350:2441–2451CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Barann M, Linden I, Witten S, Urban BW (2008) Molecular actions of propofol on human 5-HT3A receptors: enhancement as well as inhibition by closely related phenol derivatives. Anesth Analg 106:846–857CrossRefPubMedGoogle Scholar
  20. 20.
    Schelling G, Hauer D, Azad SC et al (2006) Effects of general anesthesia on anandamide blood levels in humans. Anesthesiology 104:273–277CrossRefPubMedGoogle Scholar
  21. 21.
    Borgeat A, Wilder-Smith OH, Saiah M, Rifat K (1992) Subhypnotic doses of propofol possess direct antiemetic properties. Anesth Analg 74:539–541CrossRefPubMedGoogle Scholar
  22. 22.
    Doenicke AW, Roizen MF, Rau J et al (1996) Reducing pain during propofol injection: the role of the solvent. Anesth Analg 82:472–474PubMedGoogle Scholar
  23. 23.
    Jalota L, Kalira V, George E et al (2011) Prevention of pain on injection of propofol: systematic review and meta-analysis. BMJ 342:d1110CrossRefPubMedGoogle Scholar
  24. 24.
    Picard P, Tramer MR (2000) Prevention of pain on injection with propofol: a quantitative systematic review. Anesth Analg 90:963–969CrossRefPubMedGoogle Scholar
  25. 25.
    Bennett SN, McNeil MM, Bland LA et al (1995) Postoperative infections traced to contamination of an intravenous anesthetic, propofol. N Engl J Med 333:147–154CrossRefPubMedGoogle Scholar
  26. 26.
    Matot I, Neely CF, Katz RY, Marshall BE (1994) Fentanyl and propofol uptake by the lung: effect of time between injections. Acta Anaesthesiol Scand 38:711–715CrossRefPubMedGoogle Scholar
  27. 27.
    Nitsun M, Szokol JW, Saleh HJ et al (2006) Pharmacokinetics of midazolam, propofol, and fentanyl transfer to human breast milk. Clin Pharmacol Ther 79:549–557CrossRefPubMedGoogle Scholar
  28. 28.
    Schmidt H (1998) Intubation anesthesia and nursing. Anaesthesist 47:81–82CrossRefPubMedGoogle Scholar
  29. 29.
    Reinhold P, Kraus G, Schlüter E (1998) Propofol for anesthesia and short-term sedation. The final word on use in children under three years. Anaesthesist 47:229–237CrossRefPubMedGoogle Scholar
  30. 30.
    De Smet T, Struys MM, Neckebroek MM et al (2008) The accuracy and clinical feasibility of a new bayesian-based closed-loop control system for propofol administration using the bispectral index as a controlled variable. Anesth Analg 107:1200–1210CrossRefPubMedGoogle Scholar
  31. 31.
    Hemmerling (2013) Evaluation of a novel closed-loop total intravenous anaesthesia drug delivery system: a randomizedcontrolled trial. Br J Anaesth 110(6):1031–1039CrossRefPubMedGoogle Scholar
  32. 32.
    Hornuss C, Praun S, Villinger J et al (2007) Real-time monitoring of propofol in expired air in humans undergoing total intravenous anesthesia. Anesthesiology 106:665–674CrossRefPubMedGoogle Scholar
  33. 33.
    Takita A, Masui K, Kazama T (2007) On-line monitoring of end-tidal propofol concentration in anesthetized patients. Anesthesiology 106:659–664CrossRefPubMedGoogle Scholar
  34. 34.
    Cremer OL, Moons KG, Bouman EA et al (2001) Long-term propofol infusion and cardiac failure in adult head-injured patients. Lancet 357:117–118CrossRefPubMedGoogle Scholar
  35. 35.
    Bray RJ (1998) Propofol infusion syndrome in children. Paediatr Anaesth 8:491–499CrossRefPubMedGoogle Scholar
  36. 36.
    Fudickar A, Bein B, Tonner PH (2006) Propofol infusion syndrome in anaesthesia and intensive care medicine. Curr Opin Anaesthesiol 19:404–410CrossRefPubMedGoogle Scholar
  37. 37.
    Lamberts SW, Bons EG, Bruining HA, de Jong FH (1987) Differential effects of the imidazole derivatives etomidate, ketoconazole and miconazole and of metyrapone on the secretion of cortisol and its precursors by human adrenocortical cells. J Pharmacol Exp Ther 240:259–264PubMedGoogle Scholar
  38. 38.
    Fragen RJ, Shanks CA, Molteni A, Avram MJ (1984) Effects of etomidate on hormonal responses to surgical stress. Anesthesiology 61:652–656CrossRefPubMedGoogle Scholar
  39. 39.
    Cuthbertson BH, Sprung CL, Annane D et al (2009) The effects of etomidate on adrenal responsiveness and mortality in patients with septic shock. Intensive Care Med 35:1868–1876CrossRefPubMedGoogle Scholar
  40. 40.
    Fechner J, Ihmsen H, Jeleazcov C, Schuttler J (2009) Fospropofol disodium, a water-soluble prodrug of the intravenous anesthetic propofol (2,6-diisopropylphenol). Expert Opin Investig Drugs 18:1565–1571CrossRefPubMedGoogle Scholar
  41. 41.
    Struys MM, Fechner J, Schuttler J, Schwilden H (2010) Erroneously published fospropofol pharmacokinetic-pharmacodynamic data and retraction of the affected publications. Anesthesiology 112:1056–1057CrossRefPubMedGoogle Scholar

Copyright information

© © Springer-Verlag GmbH Deutschland 2016

Authors and Affiliations

  1. 1.Klinikum der Universität München-Großhadern, Klinik für AnaesthesiologieMünchenDeutschland
  2. 2.SANDOZ Biopharmaceuticals/HEXAL AGHolzkirchenDeutschland

Personalised recommendations