Villela Nivaldo Ribeiro, Nascimento Júnior Paulo do
Departamento de Anestesiologia, FMB, Universidade Estadual Paulista.
Rev Bras Anestesiol. 2003 Feb;53(1):97-113. doi: 10.1590/s0034-70942003000100013.
Dexmedetomidine is a new alpha2-adrenergic agonist with a selectivity ratio of 1600:1 (alpha2:alpha1). It has important sedative and analgesic effects, good hemodynamic control at stress situations and may, by itself, induce anesthesia. This drug has been used to promote postoperative and intensive care sedation and analgesia. Due to such properties, dexmedetomidine has recently become a co adjuvant drug for anesthesia. So, this is a review of the literature about dexmedetomidine in anesthesia.
Major studies on dexmedetomidine in Anesthesiology are presented, both as premedication and during anesthesia. Action mechanisms of alpha2-adrenergic agonists and dexmedetomidine pharmacokinetic and pharmacodynamic properties are also reviewed in this paper.
Dexmedetomidine premedication, infusion during anesthesia or in the postoperative period improves hemodynamic stability. Anesthetic consumption is decreased during anesthesia. Patients sedated with dexmedetomidine may awake, when requested and become cooperative. Even high dexmedetomidine doses do not cause respiratory depression. Bradycardia is a frequent side effect which may be minimized by slow drug infusion. So, dexmedetomidine is an important additional resource to anesthetic practice that may be used in different patients and surgical procedures.
右美托咪定是一种新型α2肾上腺素能激动剂,其α2:α1选择性比例为1600:1。它具有重要的镇静和镇痛作用,在应激情况下能很好地控制血流动力学,且本身可能诱导麻醉。该药物已被用于促进术后和重症监护中的镇静与镇痛。由于这些特性,右美托咪定最近已成为麻醉的辅助药物。因此,这是一篇关于右美托咪定在麻醉领域的文献综述。
介绍了右美托咪定在麻醉学中的主要研究,包括作为术前用药和麻醉期间的研究。本文还综述了α2肾上腺素能激动剂的作用机制以及右美托咪定的药代动力学和药效学特性。
右美托咪定术前用药、麻醉期间输注或术后使用可改善血流动力学稳定性。麻醉期间麻醉药物用量减少。使用右美托咪定镇静的患者在需要时可苏醒并变得配合。即使高剂量右美托咪定也不会引起呼吸抑制。心动过缓是常见的副作用,可通过缓慢输注药物将其降至最低。因此,右美托咪定是麻醉实践中的一种重要补充资源,可用于不同患者和手术。