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右美托咪定在儿科患者围手术期的应用

The Perioperative Use of Dexmedetomidine in Paediatric Patients.

作者信息

Janse van Rensburg Esaias, Indiveri Laura, Mogane Palesa

机构信息

Registrar Anaesthesiology, University of Witwatersrand, Johannesburg 2193, South Africa.

Department of Anaesthesiology, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg 2193, South Africa.

出版信息

Children (Basel). 2025 May 28;12(6):690. doi: 10.3390/children12060690.

Abstract

: Dexmedetomidine, an alpha-2 adrenergic agonist, has gained significant attention for its sedative, analgesic, and anxiolytic properties in paediatric anaesthesia. This review explores its pharmacokinetics and pharmacodynamics, perioperative applications and efficacy, and safety profile in paediatric patients. : Dexmedetomidine has emerged as a highly effective adjunct in paediatric anaesthesia, offering significant advantages across various perioperative settings. It reduces the need for other anaesthetics and opioids, leading to smoother recoveries with lower postoperative pain and agitation. Studies highlight its role in enhancing procedural sedation, improving patient cooperation, and providing superior analgesia in neuraxial and general anaesthesia. Its neuroprotective properties and stable haemodynamic profile make it particularly valuable in the perioperative and critical care settings. : Dexmedetomidine has shown a favourable safety and efficacy profile in paediatric anaesthesia when doses are carefully titrated within the ranges recommended in the literature. While its use remains off-label in paediatric populations, increasing clinical experience and evidence support its integration into perioperative protocols.

摘要

右美托咪定是一种α-2肾上腺素能激动剂,因其在小儿麻醉中的镇静、镇痛和抗焦虑特性而备受关注。本综述探讨了其在小儿患者中的药代动力学和药效学、围手术期应用及疗效以及安全性。右美托咪定已成为小儿麻醉中一种高效的辅助药物,在各种围手术期情况下都具有显著优势。它减少了对其他麻醉剂和阿片类药物的需求,从而使恢复更平稳,术后疼痛和躁动减轻。研究强调了其在增强程序性镇静、改善患者配合以及在神经轴麻和全身麻醉中提供卓越镇痛方面的作用。其神经保护特性和稳定的血流动力学特征使其在围手术期和重症监护环境中特别有价值。当剂量在文献推荐范围内仔细滴定给药时,右美托咪定在小儿麻醉中已显示出良好的安全性和疗效。虽然其在儿科人群中的使用仍属超说明书用药,但越来越多的临床经验和证据支持将其纳入围手术期方案。

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本文引用的文献

1
Dexmedetomidine in neonates: utilisation trends and safety profile over time in a neonatal intensive care unit.
BMJ Paediatr Open. 2025 Mar 18;9(1):e003004. doi: 10.1136/bmjpo-2024-003004.
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Analgesia and Sedation in Critically Ill Patients With Burns.
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