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口腔颌面外科手术中术前使用右美托咪定的风险与益处:一项系统评价

Risks and benefits of pre-operative dexmedetomidine in oral and maxillofacial surgeries: a systematic review.

作者信息

Davoudi Amin, Movahedian Attar Bijan, Shadmehr Elham

机构信息

a Postgraduate student of Prosthodontics, Dental Students' Research committee, Department of Prosthodontics , School of Dentistry, Isfahan University of Medical Sciences , Isfahan , Iran.

b Dental Implants Research Center, Department of Oral and Maxillofacial Surgery , School of Dentistry, Isfahan University of Medical Sciences , Isfahan , Iran.

出版信息

Expert Opin Drug Saf. 2017 Jun;16(6):711-720. doi: 10.1080/14740338.2017.1323865. Epub 2017 May 16.

Abstract

Oral and maxillofacial surgeries might induce anxiety and pain to the patients. Sedative agents are one of the best ways for eliminating such consequences. Dexmedetomidine (DEX) is a recent sedative agent which presents higher sedative quality with greater specificity than other drugs. The aim of present paper is to evaluate the risks and benefits of administrating DEX during oral and maxillofacial surgeries by reviewing high quality released articles. Areas covered: Searches on PubMed, Scopus and Web of Science databases were completed with focus on randomized controlled trials (RCT). Related articles, from 2000 to 2015, were selected based on inclusion criteria and quality assessments factors. Full texts of the selected articles were screened and their significant information were gathered for judgments. Expert opinion: 17 RCTs on a total of 765 patients were screened. Some of the difficulties during reviewing the articles were: different pharmacokinetic and pharmacodynamics of drugs when combined with DEX, different time spots and method of monitoring, including studies on both minor and major surgeries for better data collection. Recent researches are going to focus on application of DEX for in-office procedures because of its desirable properties. Nevertheless, the analgesic and amnesic features of DEX are still questionable.

摘要

口腔颌面外科手术可能会给患者带来焦虑和疼痛。镇静剂是消除此类后果的最佳方法之一。右美托咪定(DEX)是一种新型镇静剂,与其他药物相比,具有更高的镇静质量和更高的特异性。本文旨在通过回顾高质量发表的文章,评估在口腔颌面外科手术中使用DEX的风险和益处。涵盖领域:以随机对照试验(RCT)为重点,完成了对PubMed、Scopus和科学网数据库的检索。根据纳入标准和质量评估因素,选择了2000年至2015年的相关文章。对所选文章的全文进行筛选,并收集其重要信息以供判断。专家意见:共筛选了17项涉及765例患者的RCT。文章审查过程中的一些困难包括:药物与DEX联合使用时不同的药代动力学和药效学、不同的监测时间点和方法,包括对小型和大型手术的研究以更好地收集数据。由于DEX具有理想的特性,近期研究将集中于其在门诊手术中的应用。然而,DEX的镇痛和遗忘特性仍存在疑问。

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