Dental Anesthesiology, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
Anesth Prog. 2022 Apr 1;69(1):49-58. doi: 10.2344/anpr-69-01-09.
Reversal agents are defined as any drug used to counteract the pharmacologic effects of another drug. Several pharmacologic antagonists serve as essential drugs in the contemporary practices of sedation providers and anesthesiologists. Reversal or "antidote" drugs, such as flumazenil and naloxone, are often used in unintentional overdose situations involving significant benzodiazepine- and/or opioid-induced respiratory depression. Within the context of skeletal muscle relaxation, neostigmine and sugammadex are routinely used to reverse the effects of nondepolarizing neuromuscular blocking agents. In addition, the alpha-adrenergic antagonist phentolamine is used in dentistry as a local anesthetic reversal agent, decreasing its duration of action by inducing vasodilation. This review article discusses the pharmacology, uses, practical implications, adverse effects, and precautions needed for flumazenil, naloxone, neostigmine, sugammadex, and phentolamine within the context of sedation and anesthesia practice for dentistry.
逆转剂是指用于对抗另一种药物药理作用的任何药物。几种药理学拮抗剂作为镇静提供者和麻醉师现代实践中的基本药物。逆转剂或“解毒剂”药物，如氟马西尼和纳洛酮，常用于涉及苯二氮䓬类药物和/或阿片类药物引起的呼吸抑制的意外过量情况。在骨骼肌松弛的情况下，新斯的明和氨甲环酸通常用于逆转非去极化神经肌肉阻滞剂的作用。此外，α-肾上腺素能拮抗剂酚妥拉明在牙科中用作局部麻醉剂逆转剂，通过诱导血管扩张来缩短其作用持续时间。本文综述了氟马西尼、纳洛酮、新斯的明、氨甲环酸和酚妥拉明在牙科镇静和麻醉实践中的药理学、用途、实际意义、不良反应和注意事项。
