Roosens E, Mulier J P, Heylens G, De Fruyt J
Tijdschr Psychiatr. 2017;59(9):554-558.
In clinical practice antipsychotics, benzodiazepines and/or antihistamines are used to calm agitated patients. If agitation persists and patients have contraindications for these substances, then anesthetics, such as propofol, can also be used as well, to serve as a sedative. Our attention was drawn to a particular case in which dexmedetomidine was used as a sedative.
AIM: To study the literature on the use of α2-agonists, such as dexmedetomidine, in the treatment of extreme agitation.
METHOD: We reviewed the relevant scientific literature.
RESULTS: α2-agonists, such as dexmedetomidine, are new anesthetic agents that have analgetic and sympatholytic effects without suppressing respiration. These agents are used frequently in intensive care because their sedative effect are short-lived and do not cause amnesia, sleep deprivation or cognitive disturbance. Excited delirium syndrome (eds) is a type of extreme agitation for which dexmedetomidine can be used.
CONCLUSION: There may well be a place for dexmedetomidine in the treatment of extreme agitation when standard treatments have failed. Further research is needed in order to ascertain whether dexmedetomidine should play a role in such treatment.
在临床实践中,抗精神病药、苯二氮䓬类药物和/或抗组胺药被用于使烦躁不安的患者镇静下来。如果烦躁持续存在且患者对这些药物有禁忌证,那么麻醉药,如丙泊酚,也可作为镇静剂使用。我们注意到了一个使用右美托咪定作为镇静剂的特殊病例。
研究关于使用α2激动剂,如右美托咪定,治疗极度烦躁的文献。
我们查阅了相关科学文献。
α2激动剂,如右美托咪定,是新型麻醉药,具有镇痛和抗交感神经作用,且不抑制呼吸。这些药物常用于重症监护,因为它们的镇静作用持续时间短,不会导致失忆、睡眠剥夺或认知障碍。激越性谵妄综合征(EDS)是一种可使用右美托咪定治疗的极度烦躁类型。
当标准治疗失败时,右美托咪定在治疗极度烦躁方面很可能有一席之地。需要进一步研究以确定右美托咪定是否应在这种治疗中发挥作用。