七氟醚致意识消失的机制研究进展

Research progress on the mechanism of loss of consciousness induced by sevoflurane

七氟醚是一种常见的全身麻醉剂,可用于吸入诱导和麻醉维持。目前,针对七氟醚致意识消失机制的研究取得了一定进展。针对微观分子靶点的研究证实,γ‑氨基丁酸(GABA)A型(GABAA)受体、乙酰胆碱(ACh)受体和超极化激活环状核苷酸门控(HCN)通道是七氟醚诱导意识消失的潜在靶点,然而其具体机制还需要更深入的研究。在介观的神经环路方面,多个睡眠‑觉醒相关核团以及神经环路参与七氟醚诱导的意识消失。此外,宏观的非侵入性脑成像技术揭示了七氟醚麻醉下意识相关的神经振荡、功能连接和网络拓扑结构的改变。文章从多层面探讨七氟醚致意识消失机制,为临床意识状态的监测提供了重要依据,为实现精准麻醉奠定了基础。

Sevoflurane is a common general anesthetic that can be used for inhalation induction and anesthesia maintenance.Recent years have seen some research progress on the mechanism of unconsciousness caused by sevoflurane.Studies concerning microscopic molecular targets have confirmed that type A receptors forγ‑aminobutyric acid(GABA)(GABAA),nicotinic acetylcholine(Ach)receptors,and hyperpolarization‑activated cyclic nucleotid‑gated(HCN)channels are potential targets for loss of consciousness induced by sevoflurane,but the detailed mechanisms remain to be explored.In terms of mesoscopic neural circuits,multiple nucleus and neural circuits related to sleep‑awake are involved in the sevoflurane‑induced loss of consciousness.In addition,macroscopic non‑invasive brain imaging techniques have revealed changes in consciousness‑related neural oscillations,functional connectivity,and network topology under sevoflurane anesthesia.This review introduces the mechanism of unconsciousness induced by sevoflurane from multiple aspects,which provides substantial evidence for monitoring clinical consciousness and lays a foundation for realizing precision anesthesia.