网站首页期刊介绍通知公告编 委 会投稿须知电子期刊广告合作联系我们
最新消息:
右美托咪定在麻醉中的应用研究进展
作者:倪娟  王力甚 
单位:华中科技大学同济医学院附属荆州医院 麻醉科, 湖北 荆州 434020
关键词:右美托咪定 临床药理 临床麻醉 综述 
分类号:R453
出版年·卷·期(页码):2019·47·第三期(363-367)
摘要:

右美托咪定是一种α-2肾上腺素能受体激动剂,具有良好的镇静、抗焦虑、抑制交感神经和减少镇痛药用量的作用,对呼吸系统抑制程度轻微,目前已在临床麻醉中得到了广泛应用。作者对右美托咪定的临床药理,右美托咪定在全麻醉下腹腔镜手术、肝胆手术、心肺手术、颅脑手术以及耳鼻咽喉手术中对呼吸和循环的影响,右美托咪定在椎管内麻醉与神经阻滞等非全麻中的应用、在小儿麻醉与镇痛中的应用以及其不良反应等进行综述,以期进一步指导临床麻醉工作。

参考文献:

[1] WEERINK M A,STRUYS M M,HANNIVOORT L N,et al.Clinical pharmacokinetics and pharmacodynamics of dexmedetomidine[J].Clin Pharmacokinet,2017,56(8):893-913.
[2] CHOI J W,JOO J D,KIM D W,et al.Comparison of an intraoperative infusion of dexmedetomidine,fentanyl,and remifentanil on perioperative hemodynamics,sedation quality,and postoperative pain control[J].J Korean Med Sci,2016,31(9):1485-1490.
[3] JUNG H S,JOO J D,JEON Y S,et al.Comparison of an intraoperative infusion of dexmedetomidine or remifentanil on perioperative haemodynamics,hypnosis and sedation,and postoperative pain control[J].J Int Med Res,2011,39(5):1890-1899.
[4] SHARMA R,GUPTA R,CHOUDHARY R,et al.Postoperative analgesia with intravenous paracetamol and dexmedetomidine in laparoscopic cholecystectomy surgeries:a prospective randomized comparative-study[J].Int J Appl Basic Med Res,2017,7(4):218-222.
[5] LI C W,LI Y D,WANG K,et al.Comparative evaluation of remifentanil and dexmedetomidine in general anesthesia for cesarean delivery[J].Med Sci Monit,2015,21:3806-3813.
[6] BATRA A,VERMA R,BHATIA V K,et al.Dexmedetomidine as an anesthetic adjuvant in intracranial surgery[J].Anesth Essays Res,2017,11(2):309-313.
[7] KIM H,MIN K T,LEE J R,et al.Comparison of dexmedetomidine and remifentanil on airway reflex and hemodynamic changes during recovery after craniotomy[J].Yonsei Med J,2016,57(4):980-986.
[8] MIRKHESHTI A,MEMARY E,HONAR B N,et al.The efficacy of local dexmedetomidine during fiberoptic nasotracheal intubation:a randomized clinical trial[J].J Anaesthesiol Clin Pharmacol,2017,33(2):209-214.
[9] LEE H S,YOON H Y,JIN H J,et al.Can dexmedetomidine influence recovery profiles from general anesthesia in nasal surgery?[J].Otolaryngol Head Neck Surg,2018,158(1):43-53.
[10] LEE S H,KIM N,LEE C Y,et al.Effects of dexmedetomidine on oxygenation and lung mechanics in patients with moderate chronic obstructive pulmonary disease undergoing lung cancer surgery:a randomised double-blinded trial[J].Eur J Anaesthesiol,2016,33(4):275-282.
[11] JIANG W,WANG Q,XU M,et al.Assessment of different loading doses of dexmedetomidine hydrochloride in preventing adverse reaction after combined spinal-epidural anesthesia[J].Exp Ther Med,2017,13(6):2946-2950.
[12] SINGH D R,NAG K,NAGELLA A B,et al.Efficacy of dexmedetomidine infusion for procedural comfort and intraoperative sedation in patients undergoing surgeries with subarachnoid block:a randomized double-blind clinical trial[J].Anesth Essays Res,2017,11(2):294-299.
[13] FARAJ W A,AMIR A,RICHARD B.The facilitatory effects of intravenous dexmedetomidine on the duration of spinal anesthesia:a systematic review and meta-analysis[J].Survey of Anesthesiology,2014,117(1):271-278.
[14] KAPINEGOWDA S T,ANANDSWAMY T C,NARAYANAPPA V H,et al.To compare the effects of different doses of dexmedetomidine on intrathecal-bupivacaine in infraumbilical surgeries:a prospective,randomized,double-blind-clinical study[J].Anesth Essays Res,2017,11(4):847-853.
[15] SINGH A K,KUMAR A,KUMAR A,et al.A Comparison of intrathecal dexmedetomidine and neostigmine as adjuvant to-ropivacaine for lower limb surgeries:a double-blind randomized controlled study[J].Anesth Essays Res,2017,11(4):987-992.
[16] VOROBEICHIK L,BRULL R,ABDALLAH F W,et al.Evidence basis for using perineural dexmedetomidine to enhance the quality of brachial plexus nerve blocks:a systematic review and meta-analysis of randomized controlled trials[J].Br J Anaesth,2017,118(2):167-181.
[17] BISUI B,SAMANTA S,GHOSHMAULIK S,et al.Effect of locally administered dexmedetomidine as adjuvant to levobupivacaine in supraclavicular brachial plexus block:double-blind controlled study[J].Anesth Essays Res,2017,11(4):981-986.
[18] KARIEM E B,RICHARD B,HERMAN S,et al.Perineural dexmedetomidine is more effective than clonidine when added to local anesthetic for supraclavicular brachial plexus block:a systematic review and meta-analysis[J].Anesth Analg,2017,124(6):2008-2020.
[19] NEERJA B,DINESH K S,INDU B.The analgesic efficacy of dexmedetomidine as an adjunct to local anesthetics in supraclavicular brachial plexus block:a randomized controlled trial[J].Anesth Analg,2015,121(6):1655-1660.
[20] KAUR H,ARORA P,SINGH G,et al.Dexmedetomidine as an adjunctive analgesic to ropivacaine in pectoral nerve block-in oncological breast surgery:a randomized double-blind prospective study[J].J Anaesthesiol Clin Pharmacol,2017,33(4):457-461.
[21] XU J,YANG X,HU X,et al.Multilevel thoracic paravertebral block using ropivacaine with/without-dexmedetomidine in video-assisted thoracoscopic surgery[J].J Cardiothorac Vasc Anesth,2018,32(1):318-324.
[22] 徐敏,李宝金,徐莉,等.右美托咪定复合地佐辛用于肝癌切除术后PCIA对机体细胞免疫功能的影响[J].东南大学学报(医学版),2017,36(1):100-103.
[23] 陈岩.右美托咪定联合喷他佐辛对老年患者全髋关节置换术后的镇痛效果及炎症因子、Fib和D-二聚体水平的影响[J].东南大学学报(医学版),2017,36(6):934-937.
[24] LOPEZ M M,ZECH D,LINTON J L,et al.Dexmedetomidine decreases postoperative pain and narcotic use in children undergoing alveolar bone graft surgery[J].Cleft Palate Craniofac J,2018,55(5):688-691.
[25] ZHANG B,WANG G,LIU X,et al.The opioid-sparing effect of perioperative dexmedetomidine combined with-oxycodone infusion during open hepatectomy:a randomized controlled trial[J].Front Pharmacol,2018,4(8):940.
[26] MORGAN L G,NGAI L,FELIX T,et al.Dexmedetomidine reduces propofol and remifentanil requirements during bispectral index-guided closed-loop anesthesia:a double-blind,placebo-controlled trial[J].Anesth Analg,2018,118(5):946-955.
[27] IRENE R,JULIA M,MARCIA B,et al.Dexmedetomidine does not affect evoked potentials during spine surgery[J].Anesth Analg,121(2):492-501.
[28] DAYTON D,KOWALCZYK A K.Dexmedetomidine suppressed involuntary movement in a patient with cerebral palsy[J].A&A Case Reports,2014,3(3):40-41.
[29] WANG Z,CHEN Q,GUO H,et al.Effects of dexmedetomidine on H-FABP,CK-MB,cTnI levels,neurological function-and near-term prognosis in patients undergoing heart valve replacement[J].Exp Ther Med,2017,14(6):5851-5856.
[30] JOOSTE E H,HAMMER G B,REYES C R,et al.Phase Ⅳ,open-label,safety study evaluating the use of dexmedetomidine in pediatric patients undergoing procedure-type sedation[J].Front Pharmacol,2017,11(8):529.
[31] PENG K,WU S R,JI F H,et al.Premedication with dexmedetomidine in pediatric patients:a systematic review and meta-analysis[J].Clinics (Sao Paulo),2014,69(11):777-786.
[32] PASIN L,FEBRES D,TESTA V,et al.Dexmedetomidine vs midazolam as preanesthetic medication in children:a meta-analysis of randomized controlled trials[J].Paediatr Anaesth,2015,25(5):468-476.
[33] NI J,WEI J F,YAO Y S,et al.Effect of dexmedetomidine on preventing postoperative agitation in children:a meta-analysis[J].PLoS One,2015,10(5):e0128450.
[34] JOHN A H,PETER J D,LAIMA P B.Dexmedetomidine as a rapid bolus for treatment and prophylactic prevention of emergence agitation in anesthetized children[J].Anesth Analge,2015,121(5):1308-1315.
[35] CHEN K Z,YE M,HU C B,et al.Dexmedetomidine vs remifentanil intravenous anaesthesia and spontaneous ventilation for airway foreign body removal in children[J].Br J Anaesth,2014,112(5):892-897.
[36] HASSAN P F,SALEH A H.Dexmedetomidine versus magnesium sulfate in anesthesia for cochlear implantation surgery in pediatric patients[J].Anesth Essays Res,2017,11(4):1064-1069.
[37] GUPTA S,SHARMA R.Comparison of analgesic efficacy of caudal dexmedetomidine versus caudal tramadol with ropivacaine in paediatric infraumbilical surgeries:a prospective,randomised,double-blinded clinical study[J].Indian J Anaesth,2017,61(6):499-504.
[38] SUN L,GUO R,SUN L.Dexmedetomidine for preventing sevoflurane-related emergence agitation in children:a meta-analysis of randomized controlled trials[J].Acta Anaesthesiol Scand,2014,58(6):642-650.
[39] KIM J,KIM S Y,LEE J H,et al.Low dose dexmedetomidine reduces emergence agitation after desflurane anaesthesia in children undergoing strabismus surgery[J].Yonsei Med J,2014,55(2):508-516.
[40] JAIN S,SETHI S,GHAI B,et al.Effect of dexmedetomidine on emergence agitation using desflurane in pediatric-cataract surgery[J].Saudi J Anaesth,2018,12(1):28-34.
[41] CAO J L,PEI Y P,WEI J Q,et al.Effects of intraoperative dexmedetomidine with intravenous anesthesia on postoperative emergence agitation/delirium in pediatric patients undergoing tonsillectomy with or without adenoidectomy:a consort-prospective,randomized,controlled clinical trial[J].Medicine (Baltimore),2016,95(49):e5566.
[42] PENG W,ZHANG T J.Dexmedetomidine decreases the emergence agitation in infant patients undergoing cleft palate repair surgery after general anesthesia[J].Anesthesiol,2015,15:145-148.
[43] JOHN A H,PETER J D,LAIMA P B,et al.Dexmedetomidine as a rapid bolus for treatment and prophylactic prevention of emergence agitation in anesthetized children[J].Anesth Analg,2015,121(5):1308-1315.
[44] TINA C S,SUNEET M,JONATHAN S S.Dexmedetomidine sedation leading to refractory cardiogenic shock[J].Anesth Analg,2008,106(6):1784-1786.
[45] LEE S H,NA S,KIM N,et al.The effects of dexmedetomidine on myocardial function assessed by tissue doppler echocardiography during general anesthesia in patients with diastolic dysfunction a consort-prospective,randomized,controlled trial[J].Medicine (Baltimore),2016,95(6):e2805.
[46] CALVIN J I,HEATHER A P,ERIN N F,et al.Risk factors for dexmedetomidine-associated hemodynamic instability in noncardiac intensive care unit patients[J].Anesth Analg,2016,122(2):462-469.

服务与反馈:
文章下载】【发表评论】【查看评论】【加入收藏
提示:您还未登录,请登录!点此登录
您是第 747557 位访问者


 ©《现代医学》编辑部
联系电话:025-83272481;83272479
电子邮件: xdyx@pub.seu.edu.cn

苏ICP备09058541