国际麻醉学与复苏杂志   2017, Issue (5): 6-6
    
右美托咪定与产科麻醉镇痛相关的研究及探讨
邓喆1()
1.广西医科大学第九附属医院北海市人民医院 麻醉科
Application of dexmedetomidine in obstetric anesthesia & analgesia
 全文:
摘要:

背景 目前国内关于右美托咪定(dexmedetomidine, Dex)用于产科临床研究相对较少,然而越来越多的研究结果显示Dex在产科麻醉镇痛方面具有独特优势。 目的 对近年来Dex应用于产科麻醉镇痛的相关研究进行介绍,并进一步探讨。 内容 Dex已被证实可安全应用于新生儿全身麻醉而无或极少有副作用,同时不少临床研究报道证实了其减少七氟醚和氯胺酮引起毒性反应的作用。Dex已被用于产科静脉复合麻醉及蛛网膜下腔麻醉。在这些应用中,Dex体现出了减轻围产期寒战、恶心呕吐,维持全身麻醉剖宫产正常宫缩的作用。Dex较轻的呼吸抑制作用和可唤醒镇静使之适用于产科清醒插管;然而Dex在产科麻醉镇痛方面的用药目前仍属超说明书范围用药,用药指南仍需更多的临床研究得以实现。 趋向 为优化产科麻醉与镇痛提供新的药物选择。

关键词: 右美托咪定; 产科麻醉; 镇痛; 临床研究
Abstract:

Background Although emerging evidence shows that dexmedetomidine (Dex) has unique advantages in obstetric anesthesia & analgesia, clinical trials using Dex as an obstetric medication have been relatively rare in China. Objective To review and discuss the benefits and potential application of Dex in obstetric anesthesia & analgesia. Content Dex is demonstrated to be a safe general anesthetics with or without minor adverse effects to neonates, and it was also reported to reduce the toxic effects of sevoflurane and ketamine on neonates. Dex has been used in obstetrics for intravenous analgesia and intrathecal anesthesia. In these applications, Dex relieves symptoms commonly seen in pregnant women during perinatal period, such as shivering, nausea, and vomiting, and maintains normal contraction of uterus during labor under general anesthesia. Dex also possesses some properties allowing it suitable for anesthesia in tracheal intubation, including minor respiratory suppression, efficient sedative action, non-effect on wakefulness. However, it is still early to apply Dex as a routine medication in obstetric anesthesia & analgesia, and further investigations are warranted to verify its safety, indications, and contraindications. Trend Dex may be a new drug choice for optimizing obstetric anesthesia & analgesia.

Key words: Dexmedetomidine; Obstetric anesthesia; Analgesia; Clinical study