Tang Chaoliang, Xia Zhongyuan
Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China.
J Pain Res. 2017 Aug 11;10:1899-1904. doi: 10.2147/JPR.S139387. eCollection 2017.
Many nociceptive, inflammatory, and neuropathic pathways contribute to perioperative pain. Although opioids have long been a mainstay for perioperative analgesia, other non-opioid therapies, and dexmedetomidine, in particular, have been increasingly used as part of a multimodal analgesic regimen to provide improved pain control while minimizing opioid-related side effects. This article reviews the evidence supporting the preoperative, intraoperative, and postoperative efficacy of dexmedetomidine as an adjuvant, and the efficacy of intravenous, spinal canal, and nerve block analgesia with dexmedetomidine for perioperative acute pain treatment. While there have not been any large-scale clinical trials conducted, the current body of evidence suggests that dexmedetomidine is suitable for use as an adjuvant analgesic at all perioperative stages. However, there are potential adverse effects, such as hypotension and bradycardia, which must be taken into consideration by clinicians.
许多伤害性、炎症性和神经性通路都会导致围手术期疼痛。尽管长期以来阿片类药物一直是围手术期镇痛的主要手段,但其他非阿片类疗法,尤其是右美托咪定,已越来越多地被用作多模式镇痛方案的一部分,以在尽量减少阿片类药物相关副作用的同时提供更好的疼痛控制。本文综述了支持右美托咪定作为辅助药物在术前、术中和术后有效性的证据,以及右美托咪定用于静脉、椎管和神经阻滞镇痛治疗围手术期急性疼痛的有效性。虽然尚未进行任何大规模临床试验,但目前的证据表明右美托咪定适用于围手术期所有阶段作为辅助镇痛药。然而,存在诸如低血压和心动过缓等潜在不良反应,临床医生必须予以考虑。