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右美托咪定用于气道相关手术和操作期间增强围手术期安全性和舒适度——简要综述与临床实践经验

Enhanced Perioperative Safety and Comfort During Airway-Related Surgeries and Procedures With Dexmedetomidine-A Brief Review and Clinical Practice Experience.

作者信息

Wang Juei-Chii, Yang Tsorng-Shyang, Chen Po-Heng, Huang Wei-Hsiu, Hsiao Szu-Yun, Wong Chih-Shung, Guo Shu-Lin

机构信息

Department of Anesthesiology, Cathay General Hospital, Taipei, Taiwan.

Department of Anesthesiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

出版信息

Asian J Anesthesiol. 2018 Jun;56(2):56-63. doi: 10.6859/aja.201806_56(2).0003.

Abstract

Dexmedetomidine, an α-2 adrenergic receptor agonist, provides analgesia, sedation, anxiolysis, sympatholysis and anesthetic-sparing effect, without inducing significant respiratory depression. Due to these properties, its clinical use is no longer limited to serving as a sedative agent in the intensive care unit. Proper airway management and the avoidance of cardiac and respiratory complications are common goals of everyday anesthesia practice. Ensuring airway safety is pivotal during the anesthesia stages of induction, maintenance and recovery. In this review, we focus on the advantages of dexmedetomidine in awake fiberoptic intubation (AFOI), diagnostic examinations and surgeries of patients with obstructed airways, and reducing emergence delirium effectively without causing further adverse events. With increasing implementation in different anesthetic scenarios, dexmedetomidine provides a favorable option to enhance patient safety and comfort.

摘要

右美托咪定是一种α-2肾上腺素能受体激动剂,具有镇痛、镇静、抗焦虑、交感神经阻滞和麻醉辅助作用,且不会引起明显的呼吸抑制。由于这些特性,其临床应用不再局限于在重症监护病房用作镇静剂。妥善的气道管理以及避免心脏和呼吸并发症是日常麻醉实践的共同目标。在麻醉诱导、维持和恢复阶段确保气道安全至关重要。在本综述中,我们重点关注右美托咪定在清醒纤维支气管镜插管(AFOI)、气道梗阻患者的诊断检查和手术中的优势,以及有效减少苏醒期谵妄且不引起进一步不良事件。随着在不同麻醉场景中的应用不断增加,右美托咪定提供了一个有利于提高患者安全性和舒适度的选择。

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