Gallego-Ligorit Lucía, Vives Marc, Vallés-Torres Jorge, Sanjuán-Villarreal T Alberto, Pajares Azucena, Iglesias Mario
Department of Anesthesiology and Critical Care Medicine, Cardiovascular and Thoracic Anesthesia Section,Hospital Universitario Miguel Servet, Zaragoza, Spain.
Department of Anesthesiology and Critical Care Medicine, Hospital de Bellvitge, Barcelona, Spain.
J Cardiothorac Vasc Anesth. 2018 Jun;32(3):1426-1438. doi: 10.1053/j.jvca.2017.11.044. Epub 2017 Dec 2.
Dexmedetomidine is a highly selective α-adrenergic agonist with analgesic and sedative properties. In the United States, the Food and Drug Administration approved the use of the drug for short-lasting sedation (24 h) in intensive care units (ICUs) in patients undergoing mechanical ventilation and endotracheal intubation. In October 2008, the Food and Drug Administration extended use of the drug for the sedation of nonintubated patients before and during surgical and nonsurgical procedures. In the European Union, the European Medicine Agency approved the use of dexmedetomidine in September 2011 with a single recognized indication: ICU adult patients requiring mild sedation and awakening in response to verbal stimulus. At present, the use of dexmedetomidine for sedation outside the ICU remains an off-label indication. The benefits of dexmedetomidine in critically ill patients and in cardiac, electrophysiology-related, vascular, and thoracic procedures are discussed.
右美托咪定是一种具有镇痛和镇静特性的高选择性α-肾上腺素能激动剂。在美国，食品药品监督管理局批准该药物用于接受机械通气和气管插管的重症监护病房（ICU）患者的短期镇静（24小时）。2008年10月，食品药品监督管理局扩大了该药物的用途，用于手术和非手术过程中及之前非插管患者的镇静。在欧盟，欧洲药品管理局于2011年9月批准使用右美托咪定，其单一认可适应症为：需要轻度镇静并能对言语刺激做出反应而苏醒的ICU成年患者。目前，右美托咪定在ICU以外用于镇静仍属于超说明书用药适应症。本文讨论了右美托咪定在危重症患者以及心脏、电生理相关、血管和胸科手术中的益处。
