PDF(Pubmed)
Abstract：
Caffeine has a multitude of uses in anaesthesia, and numerous studies have evaluated its efficacy and usefulness in various aspects of anaesthesia and medical practice. Its various applications in anaesthesia include its role in awakening from anaesthesia, managing post-dural puncture headache, managing post-sedation paradoxical hyper-activity in children, post-operative bowel paralysis, and apnoea in paediatric populations, that is, apnoea in infancy, paediatric obstructive apnoea, and post-anaesthetic apnoea in pre-mature infants. Though the effects of caffeine on bronchial smooth muscle, neurological, and cardio-vascular systems are well known, the relatively little-known effects on the endocrine and gastro-intestinal (GI) system have been recently taking primacy for eliciting its therapeutic benefits. The literature shows encouraging evidence in favour of caffeine, but unambiguous evidence of caffeine benefits for patients is lacking and needs further investigation. In this narrative review of literature, we summarise the available literature to provide insights into the pharmacokinetics, pharmacodynamics, clinical application of caffeine in modern anaesthetic practice, and evidence available in this field to date. An awareness of the various physiological effects, adverse effects, reported applications, and their evidence will widen the horizon for anaesthesiologists to increase its rational use and advance research in this field. Well-designed randomised controlled trials regarding the various outcomes related to caffeine use in anaesthesia should be planned to generate sound evidence and formulate recommendations to guide clinicians.
摘要：
咖啡因在麻醉中有多种用途，许多研究已经评估了其在麻醉和医疗实践的各个方面的功效和有用性。它在麻醉中的各种应用包括从麻醉中唤醒的作用，硬膜穿刺后头痛的管理，管理儿童镇静后矛盾的过度活动，术后肠麻痹,儿科人群的呼吸暂停，也就是说,婴儿期呼吸暂停，小儿阻塞性呼吸暂停，和早产儿的麻醉后呼吸暂停。虽然咖啡因对支气管平滑肌的影响，神经学,心血管系统是众所周知的，对内分泌和胃肠道（GI）系统的相对鲜为人知的影响最近被认为是引起其治疗益处的首要因素。文献显示了令人鼓舞的证据支持咖啡因，但目前缺乏咖啡因对患者有益的明确证据，需要进一步调查。在这篇文献叙事综述中，我们总结了现有的文献，以提供对药代动力学的见解，药效学,咖啡因在现代麻醉实践中的临床应用，以及迄今为止该领域的证据。意识到各种生理效应，不利影响，报告的应用程序，他们的证据将为麻醉师增加其合理使用和推进该领域的研究拓宽视野。关于麻醉中使用咖啡因相关的各种结果的精心设计的随机对照试验应计划产生可靠的证据并制定建议以指导临床医生。
