Department of Anesthesiology, School & Hospital of Stomatology, China Medical University, 117# North Nanjing Street, Shenyang 110002, PR China.
Department of Oral and Maxillofacial Surgery, School & Hospital of Stomatology, China Medical University, 117# North Nanjing Street, Shenyang 110002, PR China.
Neurosci Lett. 2014 Feb 21;561:7-12. doi: 10.1016/j.neulet.2013.12.039. Epub 2013 Dec 25.
Dexmedetomidine was initially approved for clinical use as a sedative. Its development in pain management has been limited. Dexmedetomidine has analgesic effects and analgesic-sparing properties, especially for patients with obstructed airways. Mixing dexmedetomidine with local anesthetics is a promising new avenue to enhance local anesthetics' effectiveness. Peripheral, spinal and supraspinal α(2A)-ARs are responsible for the analgesic function of dexmedetomidine. Animal studies have shown that antinociceptive synergism results from co-application of dexmedetomidine and opioids or local anesthetics. Dexmedetomidine has potential adverse effects such as hypotension and bradycardia. Therefore, dexmedetomidine is contraindicated for patients suffering from bradycardia or using β-adrenergic antagonists. Clinical trials of dexmedetomidine in chronic pain or hyperalgesia are lack.
右美托咪定最初被批准用于临床镇静。它在疼痛管理中的应用受到限制。右美托咪定具有镇痛作用和镇痛节省特性，特别是对气道阻塞的患者。将右美托咪定与局部麻醉剂混合是增强局部麻醉剂效果的一种有前途的新方法。外周、脊髓和脊髓上的α（2A）-AR 负责右美托咪定的镇痛功能。动物研究表明，右美托咪定与阿片类药物或局部麻醉剂联合应用可产生协同镇痛作用。右美托咪定有低血压和心动过缓等潜在的不良反应。因此，心动过缓和正在使用β肾上腺素能拮抗剂的患者禁用右美托咪定。右美托咪定在慢性疼痛或痛觉过敏中的临床试验缺乏。
