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Pharmakologie und Toxikologie der Lokalanästhetika

  • R. Von Krebs
Part of the Klinische Anästhesiologie und Intensivtherapie book series (KAI, volume 18)

Zusammenfassung

Unter Lokalanästhesie ist eine an umschriebener morphologischer Stelle erfolgende reversible Blockade der Leitfähigkeit sensible Nerven zu verstehen. Im Prinzip kann die Nervenleitung durch Substanzen ganz unterschiedlicher chemischer Struktur unterbrochen werden (z. B. Barbiturate, Alkohole, verschiedenste aromatische Verbindungen, ß-Rezeptorenblocker, Antihistaminika). Beieinigen dieser Substanzen, wie z. B. höher konzentrierten Lösungen von Phenol, beruht die anästhesierende Wirkung auf einer morphologischen Schädigung des Nerven. Unter klinisch verwendbaren Lokalanasthetika werden jedoch Substanzen subsurnrniert, die im Idealfalle keinerlei morphologische Veränderungen bewirken, sondern ausschließlich zeitlich begrenzte Funktionsanderungen am Nerven hervorrufen. Diese Forderung nach reversibler funktioneller Blockade der Leitfähigkeit sensibler Nerven erftillen zwei Typen von Lokalanästhetika:
  • Lokalanästhetika vorn Estertyp: Procain, Chloroprocain, Tetracain, Piperocaine.

  • Lokalanästhetika vom Arnidtyp: Lidocain, Mepivacain, Prilocain, Bupivacain, Etidocain.

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