Mato M, Pérez A, Otero J, Torres L M
Servicio de Anestesiología, Reanimación y Tratamiento del Dolor, Hospital Universitario Puerta del Mar, Cádiz.
Rev Esp Anestesiol Reanim. 2002 Oct;49(8):407-20.
Surgical patients and others admitted to recovery and intensive care units require sedation and pain therapy, for which a range of pharmaceuticals is available. Their use is more or less widespread, but other drugs, such as dexmedetomidine, have been and continue to be studied for application in such patients. Dexmedetomidine, a compound derived from imidazole, has a high affinity for the alpha-2 adrenoreceptor, on which it acts as a potent agonist. A large number of laboratory and animal studies have been performed, as have clinical trials enrolling healthy volunteers or patients with the aim of shedding shed light on the main pharmacological features of dexmedetomidine. As a result, dexmedetomidine is known to have sedative, hypnotic and analgesic properties. It diminishes the need for other anesthetics and sympathicolytics, and it reduces catecholamine release. Controlled clinical trials have looked at the use of dexmedetomidine in patients who require sedation and analgesia in postoperative intensive care units. Research shows that dexmedetomidine lowers the need both for other sedatives, such as propofol or midazolam, and for analgesic morphine. Moreover, its effect on ventilation is scarce. Dexmedetomidine is presently distributed in the United States but not in the European Union. The aim of this review was to outline the main pharmacological properties of dexmedetomidine, including its pharmacokinetics and pharmacodynamics, to give an overall view of this promising drug.
手术患者以及入住康复和重症监护病房的其他患者需要镇静和疼痛治疗,有一系列药物可用于此。它们的使用或多或少较为广泛,但其他药物,如右美托咪定,一直在并将继续针对此类患者的应用进行研究。右美托咪定是一种源自咪唑的化合物,对α-2肾上腺素能受体具有高亲和力,在该受体上它作为一种强效激动剂起作用。已经进行了大量的实验室和动物研究,也开展了招募健康志愿者或患者的临床试验,目的是阐明右美托咪定的主要药理学特征。因此,已知右美托咪定具有镇静、催眠和镇痛特性。它减少了对其他麻醉剂和交感神经阻滞剂的需求,并减少了儿茶酚胺的释放。对照临床试验研究了右美托咪定在术后重症监护病房中需要镇静和镇痛的患者中的使用情况。研究表明,右美托咪定既降低了对其他镇静剂(如丙泊酚或咪达唑仑)的需求,也降低了对镇痛吗啡的需求。此外,它对通气的影响很小。右美托咪定目前在美国有销售,但在欧盟没有。本综述的目的是概述右美托咪定的主要药理学特性,包括其药代动力学和药效学,以全面了解这种有前景的药物。