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右美托咪定作为一种短期使用的镇痛药物在未成熟神经系统中的应用。

Dexmedetomidine as a Short-Use Analgesia for the Immature Nervous System.

机构信息

Laboratory of New Engineering Solutions for Modern Laboratory Research, Kazan Federal University, Kazan 420008, Russia.

Institut de Neurobiologie de la Méditerranée (INMED U1249), Aix-Marseille University, 13273 Marseille, France.

出版信息

Int J Mol Sci. 2024 Jun 9;25(12):6385. doi: 10.3390/ijms25126385.

Abstract

Pain management in neonates continues to be a challenge. Diverse therapies are available that cause loss of pain sensitivity. However, because of side effects, the search for better options remains open. Dexmedetomidine is a promising drug; it has shown high efficacy with a good safety profile in sedation and analgesia in the immature nervous system. Though dexmedetomidine is already in use for pain control in neonates (including premature neonates) and infants as an adjunct to other anesthetics, the question remains whether it affects the neuronal activity patterning that is critical for development of the immature nervous system. In this study, using the neonatal rat as a model, the pharmacodynamic effects of dexmedetomidine on the nervous and cardiorespiratory systems were studied. Our results showed that dexmedetomidine has pronounced analgesic effects in the neonatal rat pups, and also weakly modified both the immature network patterns of cortical and hippocampal activity and the physiology of sleep cycles. Though the respiration and heart rates were slightly reduced after dexmedetomidine administration, it might be considered as the preferential independent short-term therapy for pain management in the immature and developing brain.

摘要

新生儿的疼痛管理仍然是一个挑战。有多种治疗方法可以导致疼痛敏感性丧失。然而,由于副作用,寻找更好的选择仍然是开放的。右美托咪定是一种很有前途的药物;它在镇静和镇痛方面表现出了很高的疗效,并且在不成熟的神经系统中具有良好的安全性。尽管右美托咪定已经被用于新生儿(包括早产儿)和婴儿的疼痛控制,作为其他麻醉剂的辅助药物,但仍存在一个问题,即它是否会影响对不成熟神经系统发育至关重要的神经元活动模式。在这项研究中,使用新生大鼠作为模型,研究了右美托咪定对神经系统和心肺系统的药效学影响。我们的结果表明,右美托咪定在新生大鼠幼仔中具有明显的镇痛作用,并且还轻微地改变了皮质和海马活动的不成熟网络模式以及睡眠周期的生理学。虽然右美托咪定给药后呼吸和心率略有下降,但它可能被认为是不成熟和发育中大脑疼痛管理的首选独立短期治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab54/11204225/d648c8756748/ijms-25-06385-g001.jpg

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