Lokalanästhetika: Allgemeine Pharmakologie

  • K. A. Lehmann

Zusammenfassung

Lokalanästhetika sind Medikamente, deren Wirkungsmechanismus auf einer reversiblen Blockade elektrisch erregbarer Gewebe beruht. In der klinischen Anwendung zählen hierzu vornehmlich freie Nervenendigungen und Nervenfasern in der Körperperipherie bzw. im Rückenmark. Andere exzitable Strukturen im Herzen sowie im Gehirn werden natürlich ebenfalls beeinflußt; Lokalanästhetika werden deshalb auch als Antiarrhythmika bzw. Antikonvulsiva eingesetzt. Für die therapeutische Lokalanästhesie ist damit das Spektrum der wichtigsten Nebenwirkungen vorgezeichnet.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  1. 1.
    Albright GA (1979) Cardiac arrest following regional anesthesia with etidocaine or bupivacaine. Anesthesiology 51: 285–287PubMedCrossRefGoogle Scholar
  2. 2.
    Armitage EN (1986) Local anesthetic techniques for prevention of postoperative pain. Br J Anaesth 58: 790–800PubMedCrossRefGoogle Scholar
  3. 3.
    Clarkson CW, Hondeghem LM (1985) Mechanism for bupivacaine depression of cardiac conduction: fast block of sodium channels during the action potential with slow recovery from block during diastole. Anesthesiology 62: 396–405PubMedCrossRefGoogle Scholar
  4. 4.
    Covino BG (1988) Toxicity of local anesthetic agents. Acta Anaesthesiol Belg 39 (Suppl 2): 159–164PubMedGoogle Scholar
  5. 5.
    Covino BG, Vassallo HG (1976) Local Anesthetics. Mechanisms of Action and Clinical Use. The Scientific Basis of Clinical Anesthesia, Grune and Stratton, New YorkGoogle Scholar
  6. 6.
    Greene NM (1983) Uptake and elimination of local anesthetics during spinal anesthesia. Anesth Analg 62: 1013–1024PubMedCrossRefGoogle Scholar
  7. 7.
    Gribomont BF (1988) Sudden complications in regional anesthesia. Acta Anaesthesiol Belg 39 (Suppl 2): 165–170PubMedGoogle Scholar
  8. 8.
    Hille B (1977) Ionic channels of nerve: questions for the theoretical chemist. Biosystems 8: 195–199PubMedCrossRefGoogle Scholar
  9. 9.
    Hille B (1977) Local anesthetics: hydrophilic and hydrophobic pathways for the drug receptor reaction. J Gen Physiol 69: 497–515PubMedCrossRefGoogle Scholar
  10. 10.
    Hondeghem LM, Katzung BG (1984) Antiarrhythmic agents: the modulated receptor mechanism of actions of sodium and calcium channel-blocking drugs. Annu Rev Pharmacol Toxicol 24: 387–423PubMedCrossRefGoogle Scholar
  11. 11.
    Lehmann KA (1986) Pharmakokinetische und -dynamische Aspekte bei der repetitiven Anwendung von Lokalanaesthetika. In: Hempelmann G, Biscoping J (Hrsg) Kontinuierliche Verfahren der Regionalanästhesie. Astra Chemicals, S 7–26Google Scholar
  12. 12.
    Moore DC, Mather LE, Bridenbaugh LD, Thompson GE, Balfour RI Lysons DF, Horton WG (1977) Bupivacaine (Marcaine®): an evaluation of its tissue and systemic toxicity in humans. Acta Anaesthesiol Scand 21: 109–121PubMedCrossRefGoogle Scholar
  13. 13.
    Moore DC, Bridenbaugh LD, Thompson GE, Balfour RI, Horton WG (1978) Bupivacaine: a review of 11,080 cases. Anesth Analg 57: 42–53PubMedCrossRefGoogle Scholar
  14. 14.
    Nolte H (1986) Zur Problematik der Cardiotoxizität von Bupivacain 0,75%. Reg Anaesth 9: 57–59PubMedGoogle Scholar
  15. 15.
    Park WY (1988) Factors influencing distribution of local anesthetics in the epidural space. Regional Anesthesia 13: 49–57Google Scholar
  16. 16.
    Strichartz G (1976) Molecular mechanisms of nerve block by local anaesthetics. Anesthesiology 45: 421–442PubMedCrossRefGoogle Scholar
  17. 17.
    Tucker GT, Mather LE (1979) Clinical pharmacokinetics of local anaesthetics. Clin Pharmacokinet 4: 241–278PubMedCrossRefGoogle Scholar
  18. 18.
    Widman B (1975) Plasma concentrations of local anaesthetic agents in regard to absorption, distribution and elimination, with special reference to bupivacaine. Br J Anaesth 47: 231–236PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • K. A. Lehmann

There are no affiliations available

Personalised recommendations