右美托咪定在颅内动脉瘤夹闭术的应用进展

Progress in Application of Dexmedetomidine in Clipping of Intracranial Aneurysm

颅内动脉瘤夹闭手术过程中,麻醉和手术操作等强烈刺激往往会引起循环系统的剧烈波动,甚至造成动脉瘤的破裂出血,直接影响手术的成败和患者的预后。因此,麻醉医生需要在手术过程中与术者密切配合,尤其要做到尽量维持患者血流动力学的稳定,减轻围术期伤害性刺激引起的应激反应,提高手术的安全性。右美托咪定是一种新型的具有高度选择性的α2-肾上腺素受体激动剂,具有镇静、镇痛、催眠、抗焦虑和解交感作用,对呼吸无明显影响,有利于维持血流动力学稳定,不会造成苏醒延迟,并有一定的脑保护作用,目前广泛地应用于颅内动脉瘤夹闭术患者,可以减少动脉瘤破裂和再出血等不良反应的发生,是一种良好的麻醉辅助药物。本文就右美托咪定在颅内动脉瘤夹闭术患者的应用进行综述,为临床提供一定的参考和理论基础。

In the process of the intracranial aneurysm clipping,anesthesia and surgery tend to cause severe fluctuation of cardiovascular system and even result in aneurysm rupture,which directly affects success of operation and prognosis of patients.Therefore,anesthesiologists need to work closely with surgeons to stabilize the hemodynamics,reduce the perioperative nociceptive stimulation-induced stress response,and improve the safety of operation.Dexmedetomidine（DEX）a highly selectiveα2-adrenergic agonist,exerts sedative,analgesic,hypnotic,anxiolytic,sympatholytic and neuroprotective effects,and has no obvious influence on respiration.Furthermore,DEX treatment is conductive to the hemodynamic stability and does not prolong the recovery time.As a good auxiliary anesthetic drug,DEX is widely used in patients with intracranial aneurysm clipping for reducing the adverse reactions such as aneurysm rupture and rebleeding.This paper reviews the application of DEX in patients with intracranial aneurysm clipping and provides reference and theoretical basis for clinical practice.