右美托咪定作为局部麻醉辅助剂的安全性和有效性。
Safety and efficiency of dexmedetomidine as adjuvant to local anesthetics.
作者信息
Marhofer Peter, Brummett Chad M
机构信息
aDepartment of General Anaesthesia and Intensive Care Medicine, Medical University of Vienna, Vienna, Austria bDivision of Pain Medicine, Department of Anesthesiology, The University of Michigan Medical School, Ann Arbor, Michigan, USA.
出版信息
Curr Opin Anaesthesiol. 2016 Oct;29(5):632-7. doi: 10.1097/ACO.0000000000000364.
PURPOSE OF REVIEW
To review the current knowledge of dexmedetomidine as an additive drug to local anesthetics in peripheral and neuraxial regional anesthesia.
RECENT FINDINGS
Recent studies show a perineural mode of action of dexmedetomidine. Pharmacodynamic characteristics of peripheral and neuraxial regional anesthetic techniques are optimized by the addition of dexmedetomidine to long-acting local anesthetics. Bradycardia and sedation are the main systemic side-effects of dexmedetomidine for regional anesthesia purposes. A dose of approximately 100 μg dexmedetomidine for peripheral techniques may represent the optimal balance between optimization of block characteristics and side-effects. Doses between 3 and 10 μg are described to be sufficient for spinal administration.
SUMMARY
Dexmedetomidine has a potency to ameliorate pharmacodynamic characteristics of peripheral and neuraxial regional anesthetic techniques and is therefore currently the most promising additive drug in regional anesthesia. Future scientific efforts should focus on dose finding studies for particular regional anesthetic techniques. Approval of dexmedetomidine for regional anesthetic indications should be the final target.
综述目的
综述右美托咪定作为外周和神经轴索区域麻醉中局部麻醉药添加剂的现有知识。
最新发现
近期研究显示右美托咪定的神经周围作用模式。将右美托咪定添加到长效局部麻醉药中可优化外周和神经轴索区域麻醉技术的药效学特性。心动过缓和镇静是右美托咪定用于区域麻醉的主要全身副作用。外周技术使用约100μg右美托咪定的剂量可能代表了阻滞特性优化与副作用之间的最佳平衡。3至10μg的剂量被描述为用于脊髓给药足够。
总结
右美托咪定有改善外周和神经轴索区域麻醉技术药效学特性的潜力，因此是目前区域麻醉中最有前景的添加剂药物。未来的科学研究应集中于特定区域麻醉技术的剂量探索研究。右美托咪定获批用于区域麻醉适应证应是最终目标。
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