Mackie S, Chambers D, Sebastian J
North West School of Anaesthesia, Health Education England North West Manchester UK.
Department of Anaesthesia Salford Royal Hospital Salford UK.
Anaesth Rep. 2022 Jul 19;10(2):e12178. doi: 10.1002/anr3.12178. eCollection 2022 Jul-Dec.
Dexmedetomidine is a versatile sedative agent widely used both in anaesthesia and intensive care. We present the case of a 32-year-old woman with a long-term history of non-prescribed intravenous opioid use who underwent elective resection of a skull base tumour. There was difficulty in achieving an adequate depth of anaesthesia despite the high levels of intravenous and volatile anaesthetic agent. Intra-operatively, a bolus and subsequent infusion of dexmedetomidine helped achieve an adequate depth of anaesthesia. This report highlights some of the benefits of dexmedetomidine for patients who are opioid tolerant, both intra- and postoperatively. It also demonstrates the wide range of beneficial effects dexmedetomidine could have when used as a rescue adjunct in neuroanaesthesia.
右美托咪定是一种用途广泛的镇静剂，在麻醉和重症监护中均有广泛应用。我们报告了一例32岁女性病例，该患者有长期非处方静脉使用阿片类药物的病史，接受了择期颅底肿瘤切除术。尽管使用了高剂量的静脉麻醉药和挥发性麻醉药，但仍难以达到足够的麻醉深度。术中，静脉推注并随后输注右美托咪定有助于达到足够的麻醉深度。本报告强调了右美托咪定对阿片类药物耐受患者在术中和术后的一些益处。它还证明了右美托咪定在神经麻醉中用作抢救辅助药物时可能产生的广泛有益效果。
