Sakaguchi Yoshiro, Takahashi Shosuke
Department of Anesthesiology and Critical Care Medicine, Kyushu University Hospital, Fukuoka 812-8581.
Masui. 2006 Jul;55(7):856-63.
Dexmedetomidine, a potent and highly selective alpha2-agonist, provides a unique "conscious sedation" (patients appear to be asleep, but are readily roused), analgesia, without respiratory depression. In order to provide a comfortable sedation to the ICU patients, careful evaluation of sedation and analgesia level, and the consistent treatment by medical teams are necessary. We may expect the usefulness of dexmedetomidine in the settings other than the ICU, from its pharmacological properties. Clinical applications of dexmedetomidine for several procedures such as awake craniotomy, fiberoptic tracheal intubation, or MRI examination have been reported, suggesting its usefulness and problems. The major problem with dexmedetomidine is its hemodynamic effects. Because this drug often causes hypotension, hypertension and bradycardia, it should be used under the control by skilled medical teams.
右美托咪定是一种强效且高度选择性的α2受体激动剂，可提供独特的“清醒镇静”（患者看似入睡，但很容易被唤醒）、镇痛作用，且无呼吸抑制。为了给重症监护病房（ICU）患者提供舒适的镇静，仔细评估镇静和镇痛水平以及医疗团队的持续治疗是必要的。从其药理特性来看，我们可以期待右美托咪定在ICU以外的环境中也有用处。右美托咪定在诸如清醒开颅手术、纤维支气管镜气管插管或磁共振成像（MRI）检查等多种操作中的临床应用已有报道，显示出其有用性和问题。右美托咪定的主要问题是其血流动力学效应。由于这种药物常导致低血压、高血压和心动过缓，应在专业医疗团队的控制下使用。
