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右美托咪定作为具有神经保护特性的镇痛剂:实验和临床方面。

Dexmedetomidine as an Analgesic Agent with Neuroprotective Properties: Experimental and Clinical Aspects.

机构信息

Hooman Bozorgi is with the Department of Pharmacology, Research Center of Physiology, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran. Melika Zamani is with the Department of Pharmacology, School of Pharmacy, Pharmaceutical Sciences Branch, Islamic Azad University, Tehran/Panzdah-e-Khordad Hospital, Mahdishahr, Iran. Ehsan Motaghi is with the Department of Physiology and Pharmacology, School of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran. Majid Eslami is with Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran.

出版信息

J Pain Palliat Care Pharmacother. 2021 Sep;35(3):215-225. doi: 10.1080/15360288.2021.1914280. Epub 2021 Jun 8.

Abstract

Dexmedetomidine (Dexdor or Precedex®) is considered as a sedative agent which is widely used as an adjuvant in general anesthesia and critical care practice. There is extensive evidence indicating its neuroprotective properties especially in various ischemic and hemorrhagic brain injury models of animals. Clinical trials have shown that dexmedetomidine (DEX) can improve the outcome of intensive care unit (ICU) patients. Also, DEX is appropriate as a non-opioid analgesic therapy whenever minimizing opioid-related side effects is necessary. The present article reviews the recent advances in the use of DEX as a neuroprotective agent in both animal and human studies including newest findings about the mechanism of the drug as well as analgesic efficacy of this drug at all perioperative stages. In spite of the beneficial effects of the drug on the nervous system, there are potential adverse effects, such as hypotension and bradycardia, which can be treated pharmacologically and must be taken into consideration by clinicians.

摘要

右美托咪定(Dexdor 或 Precedex®)被认为是一种镇静剂,广泛用作全身麻醉和重症监护实践的辅助剂。有大量证据表明其具有神经保护特性,特别是在各种动物的缺血性和出血性脑损伤模型中。临床试验表明,右美托咪定(DEX)可以改善重症监护病房(ICU)患者的预后。此外,DEX 是一种非阿片类镇痛药治疗方法,只要需要最小化阿片类药物相关的副作用。本文综述了 DEX 在动物和人类研究中作为神经保护剂的最新进展,包括关于药物作用机制的最新发现以及该药在所有围手术期阶段的镇痛效果。尽管该药物对神经系统有有益的影响,但存在潜在的不良反应,如低血压和心动过缓,可以通过药理学治疗,临床医生必须考虑到这些不良反应。

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