右美托咪啶在围术期临床应用的研究进展

Advance in clinical use of dexmedetomidine during perioperative period

背景 右美托咪啶（dexmedetomidine，DEX）是一种高选择性的仪α2肾上腺索受体（α2adrenoreceptor，α2AR）激动剂，于2000年3月在美国首次上市，它与饯：α1、α2肾上腺素受体结合的比例是1620：1（比可乐定高8倍）。它的半衰期比可乐定短，消除半衰期为2h，分布半衰期为6min，其较短的分布半衰期使其成为一种理想的静脉注射药。DEX具有镇静、抗焦虑和镇痛作用，还有抗交感、抑制应激反应、稳定血流动力学和减少麻醉剂用量的作用，且无呼吸抑制。目的 概述DEX的临床应用，为临床用药提供参考。内容 对DEX的药理学特点和围术期临床应用进展进行介绍。趋向 DEX将更加安全、正确、广泛的应用于临床。

Background Dexmedetomidine （DEX） is a highly selective α2 adrenoreceptor agonist, which was first marketedin March, 2000 in America. DEX has an ct2：O^l adrenoreceptor affinity ratio of approximately 1 620：1 （ eight times higher than that of clonidine）. The half-life of DEX is shorter than clonidine. The elimination half-life of DEX is 2 h and the distribution half-life of DEX is 6 min. The short half-life of DEX makes it an ideal drug for intravenous titration. DEX has been shown to have sedative, anxiolytic and analgesic effects. It has also been shown to anti sympathetic, restrain stress reaction, stabilize hemodynamic responses and reduce anesthetic requirements without relevant respiratory depression. Objective This review aims to summarize the clinical application of DEX and provide the best evidence for its clinical medication. Content This review will present the pharmacological properties and perioperative use of DEX. Trend DEX will be utilized clinicallymuch more safely, perfectly and widely during perioperative period in future.