Gerresheim G, Schwemmer U
Klinik für Anästhesiologie und Intensivmedizin, Klinikum Neumarkt i.d. OPf., Nürnberger Str. 12, 92318, Neumarkt i.d. Opf, Deutschland.
Anaesthesist. 2013 Aug;62(8):661-74. doi: 10.1007/s00101-013-2206-6.
Dexmedetomidine is a highly selective α2-receptor agonist with sedative, analgetic and anxiolytic effects. It is chemically related to clonidine and has been an authorized drug in Europe since September 2011. Dexmedetomidine enables a level of sedation in which mechanically ventilated patients may be woken by verbal stimulation (Richmond agitation sedation scale RASS 0--3). In this respect dexmedetomidine achieves the same desired effect as propofol and midazolam; however, in direct comparison to a sedation regime with benzodiazepines, dexmedetomidine reduces the prevalence, duration and severity of delirium in intensive care. Patients sedated by dexmedetomidine can statistically be extubated earlier and an influence on duration of stay in the intensive care unit (ICU) has not been shown. Daily therapy costs are approximately 5 times higher than those of propofol but an objective standpoint in relation to clinical cost efficiency is unattainable.
右美托咪定是一种具有镇静、镇痛和抗焦虑作用的高选择性α2受体激动剂。它在化学结构上与可乐定相关，自2011年9月起在欧洲成为一种获批药物。右美托咪定可产生一定程度的镇静效果，在此状态下，接受机械通气的患者可被言语刺激唤醒（里士满躁动镇静量表RASS为0 - 3）。在这方面，右美托咪定与丙泊酚和咪达唑仑达到相同的预期效果；然而，与使用苯二氮䓬类药物的镇静方案直接相比，右美托咪定可降低重症监护中谵妄的发生率、持续时间和严重程度。接受右美托咪定镇静的患者在统计学上可更早拔管，且尚未显示对重症监护病房（ICU）住院时间有影响。每日治疗费用约为丙泊酚的5倍，但关于临床成本效益的客观观点难以达成。
