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静脉麻醉最新进展英文版和中文翻译
Recent advances in intravenous anaesthesia
Efforts to develop new hypnotic compounds continue, although several have recently failed in
development. Propofol has been reformulated in various presentations with and without preservatives.
Pharmacokinetic and pharmacodynamic differences exist between some of these
preparations, and it is currently unclear whether any have substantial advantages over the original
presentation. The use of target-controlled infusion (TCI) has been extended to include paediatric
anaesthesia and sedation. Application of TCI to remifentanil is now licensed. Linking of electroencephalogram
(EEG) monitoring to TCI for closed-loop anaesthesia remains a research tool,
although commercial development may follow. The availability of stereoisomer ketamine and
improved understanding of its pharmacology have increased non-anaesthetic use of ketamine as
an adjunct analgesic. It may be useful in subhypnotic doses for postsurgical patients with pain
refractory to morphine administration.
Br J Anaesth 2004; 93: 725–36
Keywords: anaesthetics i.v., etomidate; anaesthetics i.v., ketamine; anaesthetics i.v., ORG21465;
anaesthetics i.v., ORG25435; anaesthetics i.v., propofol; anaesthetics i.v., THRX-918661;
analgesics opioid, remifentanil
Intravenous anaesthesia (IVA) is now well established in
most areas of anaesthetic provision and is the preferred
technique for some. This review assesses the present status
of IVA, describes recent and forthcoming developments,
and addresses various related controversies and their implications.
Intravenous anaesthetics have other uses beyond the
induction and maintenance of anaesthesia, and recent developments
of relevance to clinicians are also summarized.
Material for this review was gathered from literature searching,
attendance at meetings and personal communication
with experts in the field. Priority has been given to developments
since 2000. The content has been constrained to
clinical developments and late-stage anim
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