右美托咪定在心血管手术麻醉中的应用价值和进展

Application of dexmedetomidine in cardiovascular surgery

背景 右美托咪定（dexmedetomidine， Dex）是高选择性α2肾上腺素能受体激动剂，具有镇静、镇痛、抗焦虑及抑制交感和应激反应的作用，已广泛应用于临床麻醉，近期研究表明Dex在心血管手术麻醉中有一定的应用价值。 目的 阐述Dex在心血管手术麻醉中应用的适用性、有效性和安全性，为临床应用提供参考。 内容 概述Dex在心血管手术麻醉围手术期具有的稳定血流动力学、抗心律失常、器官保护、防治术后谵妄和抗炎作用以及副作用的防范。 趋向 Dex在心血管手术麻醉中有一定的应用价值，但需要进一步研究明确Dex的临床应用范围、副作用及处理措施，以便更好地应用于临床。

Background Dexmedetomidine（Dex）, a potent selective agonist of alpha-2 adrenergic receptors, has sedative, analgesic, and anxiolytic properties. It has been widely used in clinical anaesthesia. Numerous studies revealed that Dex is a valuable anesthetic in cardiovascular surgeries. Objective To summarize the efficacy and safety of Dex in cardiovascular surgery, and to provide the knowledge for its clinical application. Content Dex is effective to maintain normal cardiovascular functions, including stabilizing hemodynamics, reversing arrhythmia, protecting myocardium, preventing postoperative delirium, and restricting inflammatory reactions. Trend Dex has particular advantages in the perioperative period of cardiovascular surgery, while further investigations should be conducted to assess indications of Dex and strategies to solve its adverse effects, before applying Dex as a routine drug in clinical practices.