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可乐定作为一种用于静脉清醒镇静的药物。

Clonidine as a drug for intravenous conscious sedation.

作者信息

Ise Tetsuya, Yamashiro Mikiko, Furuya Hideki

机构信息

Department of Anesthesiology, The Nippon Dental University School of Dentistry at Tokyo, 2-3-16 Fujimi, Chiyoda-ku, Tokyo 102-8158, Japan.

出版信息

Odontology. 2002 Sep;90(1):57-63. doi: 10.1007/s102660200009.

Abstract

Clonidine, an alpha(2)-adrenoceptor agonist, was introduced to clinical practice in the 1960s because of its antihypertensive effect. It has several beneficial actions during the perioperative period, particularly for medically compromised patients. The objective of this study was to evaluate the effects of clonidine as a drug for intravenous conscious sedation. We assessed the effects of intravenous clonidine on the hemodynamic and sympathoadrenergic responses to nociceptive stimuli and we evaluated its sedative and analgesic effects. Twenty-five volunteers aged between 23 and 25 years were included in this study. They received clonidine intravenously at 2 microg/kg. Constant-current, square-wave stimuli were delivered as nociceptive stimuli to the median nerve of the arm. We measured blood pressure, heart rate, cardiac output, and plasma concentrations of noradrenaline, adrenaline, and cortisol. The sedative and analgesic effects were measured by visual analogue scales. Changes in heart rate and blood pressure were not significantly different between the clonidine and control groups. Cardiac output tended to decrease after clonidine administration. Clonidine exerted its greatest sedative effect 30 min after injection. Noradrenaline concentration reached its nadir 15 min after clonidine administration. The time course of adrenaline concentrations was similar to that of noradrenaline. The plasma concentration of cortisol decreased in both groups. The most common adverse effect was dry mouth. In conclusion, intravenous clonidine, at a dose of 2 microg/kg, did not induce significant bradycardia, hypotension, or severe side effects in the healthy volunteer. It attenuated the adrenergic response to electrical stimulation. The results suggested that clonidine is a useful drug for intravenous sedation.

摘要

可乐定是一种α₂肾上腺素能受体激动剂,因其降压作用于20世纪60年代被引入临床实践。它在围手术期有多种有益作用,尤其对有医学合并症的患者。本研究的目的是评估可乐定作为静脉清醒镇静药物的效果。我们评估了静脉注射可乐定对伤害性刺激的血流动力学和交感肾上腺素能反应的影响,并评估了其镇静和镇痛效果。本研究纳入了25名年龄在23至25岁之间的志愿者。他们以2微克/千克的剂量静脉注射可乐定。将恒流方波刺激作为伤害性刺激施加于手臂的正中神经。我们测量了血压、心率、心输出量以及去甲肾上腺素、肾上腺素和皮质醇的血浆浓度。通过视觉模拟量表测量镇静和镇痛效果。可乐定组和对照组之间心率和血压的变化无显著差异。注射可乐定后心输出量有下降趋势。可乐定在注射后30分钟发挥最大镇静作用。去甲肾上腺素浓度在可乐定给药后15分钟降至最低点。肾上腺素浓度的时间进程与去甲肾上腺素相似。两组的皮质醇血浆浓度均降低。最常见的不良反应是口干。总之,2微克/千克剂量的静脉注射可乐定在健康志愿者中未引起显著的心动过缓、低血压或严重副作用。它减弱了对电刺激的肾上腺素能反应。结果表明可乐定是一种有用的静脉镇静药物。

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