Division of Critical Care Medicine, Department of Pediatrics, Stanford University, 770 Welch Road, Palo Alto, CA 94304, USA.
Expert Opin Drug Saf. 2011 Jan;10(1):55-66. doi: 10.1517/14740338.2010.512609. Epub 2010 Aug 18.
Dexmedetomidine is an α(2)-adrenoceptor agonist with sedative, anxiolytic and analgesic properties. It is used off-label in pediatric patients due to its efficacy and lack of adverse respiratory effects. Dexmedetomidine may cause severe circulatory complications in adults. Despite its popularity, the safety of dexmedetomidine in the pediatric population has not been extensively studied.
This article reviews the current literature (up to 2010) focusing on applications and safety of dexmedetomidine administered to pediatric patients.
Dexmedetomidine is a useful sedative and anxiolytic drug in the pediatric intensive care unit as well as during diagnostic and therapeutic procedures. Deleterious effects of dexmedetomidine include hypotension and bradycardia. Additionally, hypertension may occur during the "loading dose" or with high infusion rates. Few studies have been performed to evaluate the safety of dexmedetomidine in pediatrics. The development of tolerance and withdrawal has not been studied in children.
Despite its favorable respiratory profile, dexmedetomidine may cause deleterious cardiovascular effects. Close monitoring of circulatory dynamics and judicious titration is recommended. Further studies are needed to better define adverse effects following long-term infusions as well as in special populations such as pre-term infants.
右美托咪定是一种 α(2)-肾上腺素受体激动剂，具有镇静、抗焦虑和镇痛作用。由于其疗效和缺乏不良呼吸作用，它在儿科患者中被超适应证使用。右美托咪定可能会在成年人中引起严重的循环并发症。尽管它很受欢迎，但右美托咪定在儿科人群中的安全性尚未得到广泛研究。
本文综述了截至 2010 年的最新文献，重点关注右美托咪定在儿科患者中的应用和安全性。
右美托咪定在儿科重症监护病房以及在诊断和治疗过程中是一种有用的镇静和抗焦虑药物。右美托咪定的有害作用包括低血压和心动过缓。此外，在“负荷剂量”或高输注率期间可能会发生高血压。很少有研究评估右美托咪定在儿科的安全性。尚未在儿童中研究耐受性和戒断的发展。
尽管右美托咪定具有有利的呼吸特征，但可能会引起有害的心血管作用。建议密切监测循环动力学并谨慎滴定。需要进一步研究以更好地定义长期输注后的不良影响以及早产儿等特殊人群中的不良影响。
