右美托咪定在儿科临床镇静的应用现状

The application status of dexmedetomidine in pediatric clinical sedation

儿童检查前及术前常需要应用镇静药物使操作顺利进行。许多临床常用的麻醉镇静剂在动物研究中,被发现具有神经毒副作用;对于某些镇静药物,在应用过程中可能会产生呼吸抑制作用,这些不良反应对处于发育期的儿童是不可忽视的。右美托咪定(dexmedetomidine,DEX)是一种高选择性α2-肾上腺素受体激动剂,具有镇静及镇痛作用。通过检索国内外DEX在儿童镇静中的应用,结果显示,DEX引发并维持自然非动眼睡眠状态,产生镇静、催眠作用,镇静过程中无呼吸抑制作用,为安全有效的镇静药物。虽然DEX在我国未被推荐用于儿科镇静,但是它的应用越来越受到广大麻醉医生及药师的关注,DEX临床研究可能为儿科临床镇静提供更好的选择。

Fear before examination and operation as well as incompliance of children have always bothered doctors and children＇s parents,which need sedatives to assure performance of procedure.The common anesthetic sedatives used clinically were all observed with neurological side effects in animal studies.Several sedatives may exert respiratory depression during treatment,which can＇t be ignored for development period of children.Dexmedetomidine（DEX）is a high selectiveα2-adrenaline receptor agonist with sedating and analgesic effects.By retrieving DEX at home and abroad application in children sedation,results show that it can trigger and maintain natural non-eye movement sleep mode,lead to sedation and hypnotic effect,but no respiratory depression during the sedation.Although DEX has not been recommended for children sedation,there are more and more concerns on its application by extensive anesthetists and pharmacists,and DEX is of great applying prospect in children sedation.