医学
围手术期
乙酰半胱氨酸
麻醉
止痛药
对乙酰氨基酚
支气管痉挛
重症监护医学
药理学
内科学
生物化学
化学
抗氧化剂
哮喘
作者
Phillip Ryan Wilson,Kathryn H. Bridges,Michael D. Scofield,Sylvia H. Wilson
出处
期刊:Pain management
[Future Medicine]
日期:2024-08-21
卷期号:: 1-12
标识
DOI:10.1080/17581869.2024.2388504
摘要
Nonopioid analgesics serve to improve analgesia and limit side effects and risks of perioperative opioids. N-acetylcysteine (NAC), the primary treatment of acetaminophen toxicity, may have perioperative indications, including analgesia. NAC impacts glutathione synthesis, oxidant scavenging, glutamate receptor modulation and neuroinflammation. Potential perioperative benefits include arrhythmia prevention after cardiac surgery, decreased contrast-induced nephropathy, improved post-transplant liver function and superior pulmonary outcomes with general anesthesia. NAC may improve perioperative analgesia, with some studies displaying a reduction in postoperative opioid use. NAC is generally well tolerated with an established safety profile. NAC administration may predispose to gastrointestinal effects, while parenteral administration may carry a risk of anaphylactoid reactions, including bronchospasm. Larger randomized trials may clarify the impact of NAC on perioperative analgesic outcomes.
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