Gerlach Anthony T, Dasta Joseph F
The Ohio State University Medical Center, The Ohio State University, Columbus, OH, USA.
Ann Pharmacother. 2007 Feb;41(2):245-52. doi: 10.1345/aph.1H314. Epub 2007 Feb 13.
To review recent literature on the safety and efficacy of dexmedetomidine.
Articles were identified through searches of MEDLINE (1966-January 2007). Key words included dexmedetomidine, medetomidine, alpha(2)-agonist, and sedation. References from selected articles were reviewed for additional references.
Experimental and observational studies that focused on the safety and efficacy of dexmedetomidine in humans were selected.
Dexmedetomidine is an alpha(2)-agonist for short-term sedation in critically ill patients. In postoperative patients, dexmedetomidine produced similar levels of sedation and times to extubation, with less opioid requirements compared with propofol. Dexmedetomidine has also been studied for sedation in critically ill medical and pediatric patients, as adjunct to anesthesia, and for procedural sedation. Hypotension, hypertension, and bradycardia are common adverse effects. Although dexmedetomidine is labeled only for sedation less than 24 hours, it has been administered for longer than 24 hours without apparent development of rebound hypertension and tachycardia.
Dexmedetomidine is a safe and effective agent for sedation in critically ill patients. Further, well designed studies are needed to define its role as a sedative for critically ill medical, neurosurgical, and pediatric patients, as an adjunct to anesthesia, and as a sedative during procedures.
综述右美托咪定安全性和有效性的近期文献。
通过检索MEDLINE（1966年至2007年1月）确定文章。关键词包括右美托咪定、美托咪定、α₂激动剂和镇静。对所选文章的参考文献进行回顾以获取更多参考文献。
选择聚焦于右美托咪定在人类中的安全性和有效性的实验性和观察性研究。
右美托咪定是一种用于危重症患者短期镇静的α₂激动剂。在术后患者中，与丙泊酚相比，右美托咪定产生相似的镇静水平和拔管时间，且阿片类药物需求量更少。右美托咪定还被研究用于危重症内科和儿科患者的镇静、作为麻醉辅助以及用于操作过程中的镇静。低血压、高血压和心动过缓是常见的不良反应。虽然右美托咪定仅被标注用于小于24小时的镇静，但已被用于超过24小时，且未出现明显的反弹性高血压和心动过速。
右美托咪定是危重症患者镇静的一种安全有效的药物。此外，需要设计良好的研究来确定其作为危重症内科、神经外科和儿科患者的镇静剂、麻醉辅助剂以及操作过程中的镇静剂的作用。
