右美托咪定用于治疗伴有肌张力障碍的阵发性自主神经功能不稳定。
Dexmedetomidine for the treatment of paroxysmal autonomic instability with dystonia.
作者信息
Goddeau Richard P, Silverman Scott B, Sims John R
机构信息
Department of Neurology, University of Massachusetts Medical School, Worcester, MA, USA.
出版信息
Neurocrit Care. 2007;7(3):217-20. doi: 10.1007/s12028-007-0066-0.
INTRODUCTION
A 38-year-old man with severe head trauma complicated by paroxysmal severe intracranial pressure elevation associated with tachypnea, tachycardia, diaphoresis, and extensor posturing was diagnosed as suffering from paroxysmal autonomic instability with dystonia (PAID). These events were unresponsive to standard medical therapy, which included morphine, fentanyl, labetalol, lorazepam, metoprolol, and clonidine.
METHODS
A trial treatment with dexmedetomidine, a central acting alpha2-agonist, to control symptoms of PAID was initiated 12 days after injury. PAID-related events subsided during the 72-h infusion protocol of 0.2-0.7 mcg/kg/h. No further events were noted after termination of the 72-h infusion.
CONCLUSIONS
Dexmedetomidine may be a novel pharmacologic agent to aid in abrogating PAID.
引言
一名38岁男性，因严重头部外伤并发阵发性严重颅内压升高，伴有呼吸急促、心动过速、多汗和伸肌姿势异常，被诊断为患有阵发性自主神经功能不稳定伴肌张力障碍（PAID）。这些症状对包括吗啡、芬太尼、拉贝洛尔、劳拉西泮、美托洛尔和可乐定在内的标准药物治疗无反应。
方法
在受伤12天后开始使用中枢作用的α2激动剂右美托咪定进行试验性治疗，以控制PAID的症状。在0.2 - 0.7 mcg/kg/h的72小时输注方案期间，与PAID相关的事件消退。在72小时输注结束后未再观察到此类事件。
结论
右美托咪定可能是一种有助于消除PAID的新型药物。
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