ПРОБЛЕМЫ АНАЛЬГОСЕДАЦИИ И ПУТИ ЕЕ ОПТИМИЗАЦИИ У БОЛЬНЫХ В КРИТИЧЕСКИХ СОСТОЯНИЯХ
Аннотация
В статье рассмотрена проблема адекватной анальгоседации больных в критических состояниях, представлены различные фармакологические эффекты современных седативных и анальгетических препаратов, а также их адъювантов, назначаемых в интенсивной терапии.
Предложены современные подходы к анальгоседации больных с позиций хронофизиологии и хронофармакологии, то есть с учетом циркадных ритмов и влияния препаратов на циркадные ритмы пациента. Высказано мнение, что оптимизация времени приема препаратов будет способствовать снижению токсичности и побочных эффектов препаратов, лучшему клиническому эффекту в лечении больных.
Литература
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2. Borlongan C.V., Hayashi T., Oeltgen P.R., Su T.P., Wang Y. Hibernation-like state induced by an opioid peptide protects against experimental stroke. BMC Biol. 2009; 7: 31.
3. Wu Y.X., Hao Y.B., Dun Y., Yang S.P. Role of endogenous opioid peptides in protection of ischemic preconditioning in rat small intestine. Life Sci. 2001; 68: 1013-1019.
4. Addison P.D., Neligan P.C., Ashrafpour H., Khan A., Zhong A., Moses M. et al. Noninvasive remote ischemic preconditioning for global protection of skeletal muscle against infarction. Am J Physiol Heart Circ Physiol. 2003; 285: H1435-1443.
5. Romano M.A., Seymour E.M., Berry J.A., McNish R.A., Bolling S.F. Relative contribution of endogenous opioids to myocardial ischemic tolerance. J Surg Res. 2004; 118: 32-37.
6. Peart J.N., Gross G.J. Exogenous activation of delta-and kappa-opioid receptors affords cardioprotection in isolated murine heart. Basic Res Cardiol. 2004; 99: 29-37.
7. Zhang J., Haddad G.G., Xia Y. Delta-, but not mu-and kappa-, opioid receptor activation protects neocortical neurons from glutamate-induced excitotoxic injury. Brain Res. 2000; 885: 143-153.
8. Zhang J., Gibney G.T., Zhao P., Xia Y. Neuroprotective role of delta-opioid receptors in cortical neurons. Am J Physiol Cell Physiol. 2002; 282: C1225-1234.
9. Endoh H., Taga K., Yamakura T., Sato K., Watanabe I., Fukuda S., et al. Effects of naloxone and morphine on acute hypoxic survival in mice. Crit Care Med. 1999; 27: 1929-1933.
10. Endoh H., Honda T., Ohashi S., Shimoji K. Naloxone improves arterial blood pressure and hypoxic ventilatory depression, but not survival, of rats during acute hypoxia. Crit Care Med. 2001; 29: 623-627.
11. Chien S., Oeltgen P.R., Diana J.N., Salley R.K., Su T.P. Extension of tissue survival time in multiorgan block preparation with a delta opioid DADLE (D-Ala2, D-Leu5-enkephalin). J Thorac Cardiovasc Surg. 1994; 107: 964-967.
12. Yamakura T., Sakimura K., Shimoji K. Direct inhibition of the N-methyl-D-aspartate receptor channel by high concentrations of opioids. Anesthesiology. 1999; 91: 1053-1063.
13. Kuklin V. Survival rate in patients after sudden cardiac arrest at the University Hospital of Northern Norway treated with or without opioids: a retrospective evaluation. Saudi Journal of Anaesthesia. 2013 ; 7.(3) : 310-314.
14. Elmer J., Lynch M.J., Kristan J., Morgan P., Gerstel S.J., Callaway C.W. et al. Pittsburgh post-cardiac arrest service. Recreational drug overdose-related cardiac arrests: break on through to the other side. Resuscitation. 2015; 89: 177-181.
15. Celerier E., Gonzalez J.R., Maldonado R. et al. Opioid-induced hyperalgesia in a murine model of postoperative pain: role of nitricoxide generated from the inducible nitricoxide synthase. Anesthesiology, 2006. 104(3): 546-555.
16. Дарбинян Т.М., Баранова Л.М., Григорьянц Я.Г. и др. Нейровегетативное торможение как компонент общей анестезии. Анест и реаниматол 1983; 2: 3-9.
17. Виноградов, В. Л. Пpотокол общей анестезии на основе пpопофола пpи опеpациях у тяжелообожженных III-IV класса ASA. Анестезиология и реаниматология. 2002; 3 : 44-48.
18. Гвак Г. В. Стресс-лимитирующие системы и улучшение качества и безопасности антиноцицептивной защиты у детей при хирургической агрессии. Девятый съезд Федерации анестезиологов и реаниматологов: Тезисы докладов. Иркутск, 2004: 65-66.
19. De-Yong Liang, Guochun Liao, Jianmei Wang et al. Genetic Analysi sof Opioid-induced Hyperalgesiain Mice. Anesthesiology. 2006; 104, 5: 1054-1062.
20. J. Steinmetz, K.B. Christensen, T. Lund, N. Lohse, L.S. Rasmussen. Long-term consequences of postoperative cognitive dysfunction. Anesthesiology. 2009; 110, 3: 548-555.
21. ICU Management & Practice, T. 18, V. 4, 2018.
22. Sleigh J.W. Mechanismsof Ceneral Anesthesia. Review Course Lectures. LARS; 2007: 85-89.
23. Thiruvenkatarajan et al. The intraoperative use of non-opioid adjuvant analgesic agents: a survey of anaesthetists in Australia and New Zealand. BMC Anesthesiology (2019) 19: 188.
24. McNicol E.D., Ferguson M.C., Haroutounian S. et al. Single dose intravenous paracetamol or intravenous propacetamol for postoperative pain. Cochrane Database of Systematic Reviews 2016, Issue 5. Art. No.: CD007126.
25. Eastman P., Le B. Corticosteroids as co-analgesics with opioids for pain: a survey of Australian and New Zealand palliative care clinicians. Intern Med J. 2015; 45 (12): 1306-1310.
26. Rakhman E, Shmain D, White I, et al. Repeated and escalating preoperative subanesthetic doses of ketamine for postoperative pain control in patients undergoing tumor resection: a randomized, placebo-controlled, double-blind trial. Clin Ther. 2011; 33: 863-738.
27. Himmelseher S., Pfenninger E, Kochs E, Auchter M. S()-ketamine up-regulates neuronal regeneration associated proteins following glutamate injury in cultured rat hippocampal neurons. J Neurosurg Anesthesiol. 2000; 12: 84-94.
28. Reid K.H., Paskitti M., Guo S.Z., Schmelzer T., Iyer V. Experience with ketamine and sodium pentobarbital as anesthetics in a rat model of cardiac arrest and resuscitation. Resuscitation. 2003; 57: 201-210.
29. Chaparro L.E., Smith S.A., Moore R.A. et al. Pharmacotherapy for the prevention of chronic pain after surgery in adults. Cochrane Database Syst Rev. 2013; 24: CD008307.
30. Sun Y., Li T., Wang N. et al. Perioperative systemic lidocaine for postoperative analgesia and recovery after abdominal surgery: a meta-analysis of randomized controlled trials. Dis Colon Rectum. 2012; 55: 1183-1194.
31. Сhug S.A., Palmer G.M., Scott D.A. et al. Working Group of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine. In: Acute pain management: scientific evidence (4th edition). Melbourne: ANZCA & FPM; 2015.
32. Murphy J.D., Paskaradevan J., Eisler L.L. et al. Analgesic efficacy of continuous intravenous magnesium infusion as an adjuvant to morphine for postoperative analgesia: a systematic review and meta-analysis. Middle East J Anesthesiol. 2013; 22: 11-20.
33. Schug S.A., Palmer G.M., Scott D.A. et al. Working Group of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine. In: Acute pain management: scientific evidence (4th edition). Melbourne: ANZCA & FPM; 2015.
34. Blandszun G., Lysakowski C., Elia N. Effect of perioperative systemicalpha2 agonists on postoperative morphine con-sumption and painintensity: systematic review and meta-analysis of randomized controlled trials. Anesthesiology.2012; 116: 1312-1322.
35. Feng et al. Dexmedetomidine and sufentanil.
combination versus sufentanil alone for postoperative intravenous patientcontrolled analgesia: a systematic review and meta-analysis of randomized controlled trials BMC Anesthesiology (2019) 19: 81.
36. Fabritius M.L., Geisler A., Petersen P.L. et al. Gabapentin for post- operative pain management – a systematic review with meta- analyses and trial sequential analyses. Acta Anaesthesiol Scand. 2016; 60: 1188-1208.
37. Doleman B., Heinink T.P., Read D.J. et al. A systematic review and meta-regression analysis of prophylactic gabapentin for postoperative pain. Anaesthesia. 2015; 70: 1186-1204.
38. Watts R., Thiruvenkatarajan V., Calvert M. et al. The effect of perioperative esmolol on early postoperative pain: a systematic review and meta-analysis. J Anesthesiol Clin Pharmacol. 2017; 33: 28-39.
39. Gelineau A.M., King M.R., Ladha K.S. et al. Intraoperative Esmolol as an adjunct for perioperative opioid and postoperative pain reduction: ASystematic review, Meta-analysis, and Meta-regression. AnesthAnalg. 2018; 126: 1035-1049.
40. Cottrell J.E., Smith D.S. Anesthesia and Neurosurgery 4thEd, 2001.
41. Wei-Xia Li, Ru-Yi Luo, Chao Chen, Xiang Li, Jing-Sheng Ao, Yue Liu, Yi-Qing Yin Effects of propofol, dexmedetomidine, and midazolam on postoperative cognitive dysfunction in elderly patients: a randomized controlled preliminary trial Chin Med J (Engl) 2019; 132(4): 437-445.
42. Maldonado J.R., Wysong A., van der Starre P.J., Block T., Miller C., Reitz B.A. Dexmedetomidine and the reduction of postoperative delirium after cardiac surgery. Psychosomatics 2009; 50: 206-217.
43. Young C., Jevtovic-TodorovicV., QinY.Q. et al. Potential of ketamine and midazolam, individually or in combination, to induce apoptotic neurodegeneration in the infant mouse brain. BrJPharmacol 2005; 146: 189-197.
44. Vutskits L., Gascon E., Tassonyi E., Kiss J.Z. Clinically relevant concentrations of propofol but not midazolam alter in vitro dendritic development of isolated gammaaminobutyricacid-positive interneurons. Anesthesiology. 2005; Vol. 102, 5: 970-976.
45. Glass P.S.A., Bloom M., Kearse I. Bispectral analysis measures sedation and memory effects of propofol, midazolam, isoflurane, end alfentanil in healthy volunteers. Anesthesiol.1997; 86: 836-847.
46. Young C., Jevtovic-Todorovic V., Qin Y.Q. Potential of ketamine and midazolam, individually or in combination, to induce apoptotic neurodegeneration in the infant mouse brain. Br. J. Pharmacol. 2005; 146, 1: 189-197.
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Опубликована
2020-02-28
Как цитировать
КОЛЕСНИКОВ, А. Н. et al.
ПРОБЛЕМЫ АНАЛЬГОСЕДАЦИИ И ПУТИ ЕЕ ОПТИМИЗАЦИИ У БОЛЬНЫХ В КРИТИЧЕСКИХ СОСТОЯНИЯХ.
Университетская клиника, [S.l.], n. 1(34), p. 81-89, фев. 2020.
ISSN 1819-0464. Доступно на: <http://journal.dnmu.ru/index.php/UC/article/view/438>. Дата доступа: 21 ноя. 2024
doi: https://doi.org/10.26435/uc.v0i1(34).438.
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