Ben-Abraham R, Ogorek D, Weinbroum A A
Department of Anesthesiology and Critical Care Medicine, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Israel.
Isr Med Assoc J. 2000 Oct;2(10):793-6.
Dexmedetomidine is a relatively new, highly selective, short-acting central alpha 2 agonist. Although not yet officially introduced for clinical use in Israel, it has become increasingly popular among anesthesiologists and intensive care physicians abroad when used as an adjuvant to the classical regimen of anesthesia techniques. Its administration potentiates the effect of other sedative and hypnotic agents while causing minimal respiratory depression. It also blunts the sympathetic response--thus minimizing changes in blood pressure and heart rate--during critical moments such as laryngoscopy and intubation. However, bradycardia and hypotension may ensue. DXM minimizes opioid-induced muscle rigidity and attenuates postoperative shivering. These pro-anesthesia effects are attributed to the capability of DXM to reduce central adrenergic outflow. Although its precise mechanism(s) of action are still debatable, DXM will undoubtedly find an increasing role in clinical peri-operative anesthesia.
右美托咪定是一种相对较新的、高选择性、短效的中枢α2激动剂。尽管在以色列尚未正式引入临床使用，但在国外，当用作经典麻醉技术方案的辅助药物时，它在麻醉医生和重症监护医生中越来越受欢迎。它的给药可增强其他镇静和催眠药物的效果，同时引起最小程度的呼吸抑制。在喉镜检查和插管等关键时刻，它还能减弱交感神经反应，从而使血压和心率变化最小化。然而，可能会出现心动过缓和低血压。右美托咪定可最大限度地减少阿片类药物引起的肌肉强直，并减轻术后寒战。这些麻醉作用归因于右美托咪定减少中枢肾上腺素能流出的能力。尽管其确切的作用机制仍有争议，但右美托咪定无疑将在临床围手术期麻醉中发挥越来越重要的作用。
