右美托咪定镇痛作用的临床研究进展

Clinical application of dexmedetomidine for analgesia

背景 疼痛是困扰人类最严重的临床问题之一.在临床上,右美托咪定（dexmedetomidine,Dex）广泛应用于术前、术中和术后镇静、镇痛. 目的 探讨Dex用于围手术期镇痛是否具有显著优势. 内容 Dex具有良好的超前镇痛或辅助镇痛、稳定血流动力学、延长麻醉药的镇痛时间、降低围手术期副作用等作用,尤其是一些特殊患者的围手术期应用,如产科麻醉和小儿麻醉. 趋向 Dex围手术期镇痛最佳的用药时机、方法以及患者的选择尚需更多的研究去证实.

Background Pain is one of the most serious debilitating clinical problems.Dexmedetomidine （Dex） has been widely used for pre-,intra-,and post-operative sedation and analgesia.Objective To review the advantages of Dex in perioperative analgesia.Content Dex is a selective agonist of αr2 adrenergic receptors,and has multiple pharmacological properties,such as,analgesia,sedation,hypnosis,anti-anxiety,anti-tachycardia,etc.Perioperative administration of Dex significantly mitigates stress reaction to operation,stabilizes hemodynamics,reduces the dosage of opioids for analgesia and anesthesia,but prolongs the effects of opioids.Additionally.strong sedative effect without respiratory suppression makes Dex especially suitable for obstetric and pediatric analgesia.Cautions should be taken for the possibility that Dex may cause bradycardia in particular types of patients.Trend Although Dex is safe for perioperative analgesia,further investigations are warranted to identify more indications and contraindications.