右美托咪啶在心脏手术围术期的应用

The clinical application of dexmedetomidine in the perioperative period of cardiac surgery

背景右美托咪啶（dexmedetomidine，DEX）作为一种高效的α2受体激动剂，不仅具有镇静、镇痛、抗焦虑作用，还有使心脏高危情形受益的抗交感，心肌自律性阻滞作用，因此被越来越多的用于心脏手术围术期。目的概述及评价DEX在心脏手术围术期应用的有效性及安全性，为临床用药提供参考。内容阐述DEX心血管系统药理学特点，荟萃分析DEX在心脏手术围术期各阶段应用的具体方案及安全性。趋向DEX在心脏手术围术期中应用有独特优势，并有更广阔的前景。

Background Dexmedetomidine （DEX）, a highly potent selective alpha-2 adrenergic agonist, has not only sedative, analgesic and anxiolytic effects, but also anti-sympathetic and autorhythmicity-blockade properties which might be beneficial to high-risk cardiac situations. Therefore, its application has been increasing in the perioperative period of cardiac surgery. Objective To assess the efficacy and safety of DEX application in the perioperative period of cardiac surgery and provide evidence for its clinical application. Content This review introduced the pharmacological properties of DEX on cardiovascular system, and summarized the specific proposal and safety of DEX when used in different periods of cardiac surgery. Trend DEX has been proved to possess the unique advantages through the application in the perioperative period of cardiac surgery, and will be widely used in the future.