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右美托咪定用于神经阻滞的研究进展

陈琪 刘兴 刘红亮

陈琪, 刘兴, 刘红亮. 右美托咪定用于神经阻滞的研究进展[J]. 药学实践与服务, 2018, 36(4): 289-292. doi: 10.3969/j.issn.1006-0111.2018.04.001
引用本文: 陈琪, 刘兴, 刘红亮. 右美托咪定用于神经阻滞的研究进展[J]. 药学实践与服务, 2018, 36(4): 289-292. doi: 10.3969/j.issn.1006-0111.2018.04.001
CHEN Qi, LIU Xing, LIU Hongliang. Research progress of dexmedetomidine in nerve block[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(4): 289-292. doi: 10.3969/j.issn.1006-0111.2018.04.001
Citation: CHEN Qi, LIU Xing, LIU Hongliang. Research progress of dexmedetomidine in nerve block[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(4): 289-292. doi: 10.3969/j.issn.1006-0111.2018.04.001

右美托咪定用于神经阻滞的研究进展

doi: 10.3969/j.issn.1006-0111.2018.04.001
基金项目: 重庆市科学技术委员会重点项目(cstc2017jcyj BX0043)

Research progress of dexmedetomidine in nerve block

  • 摘要: 右美托咪定(Dex)是一种高选择性的α2肾上腺素能受体激动剂,目前作为局麻药的辅助用药在神经阻滞中取得了良好的临床效果,可缩短局麻药的起效时间、延长镇痛时效并减少术后镇痛药的使用,同其他局麻药辅助药物相比,右美托咪定可提供更优的镇痛效果和时程,以及较少的不良反应。
  • [1] DON SEBASTIAN, RAVI M, DINESH K. Comparison of dexmedetomidine and clonidine an adjuvant to ropivacaine in supraclavicular brachial plexus nerve blocks[J]. Journal of dental and medical science,2015,14(3):2279-2861.
    [2] GERTLER R, BROWN HC, MITCHELL DH, et al. Dexmedetomidine:a novel sedative-analgesic agent[J]. Proc. (Bayl Univ Med Cent), 2001, 14(1):13-21.
    [3] TALKE P, RICHARDSON CA, SCHEININ M, et al. Postoperative pharmacokinetics and sympatholytic effects of dexmedetomidine[J]. Anesth Analg,1997; 85(5):1136-1142.
    [4] TAIJI K. Dexmedetomidine hydrochloride (Precedex), a new sedative in intensive care, its pharmacological characteristics and clinical study result[J]. Nippon Yakurigaku Zasshi,2004,124(3):171-179.
    [5] DUKA I, GAVRAS I, JOHNS C,et al. Role of the postsynaptic alpha(2)-adrenergic receptor subtypes in catecholamine-induced vasoconstriction[J]. Gen Pharmacol,2000,34(2):101-106.
    [6] TURAN A,MEMIS D,KAYA G, et al. The prevention of pain from injection of propofol by dexmedetomidine and comparison with lidocaine[J].Can J Anaesth,2005,52(5):548-549.
    [7] AGARWAL S, AGGARWAL R, GUPTA P. Dexmedetomidine prolongs the effect of bupivacaine in supraclavicular brachial plexus block[J].Anaesthesiol Clin Pharmacol,2014, 30(1):36-40.
    [8] DAR FA, NAJAR MR, JAN N.Dexmedetomidine Added to Ropivacaine Prolongs Axillary Brachial Plexus Block[J].International Journal of Biomedical and Advance Research,2013, 4(10):719-722.
    [9] ZHANG Y, WANG CS, SHI JH, et al. Perineural administration of dexmedetomidine in combination with ropivacaine prolongs axillary brachial plexus block[J]. Int J Clin Exp Med,2014; 7(3):680-685.
    [10] BHARTI N, SARDANA DK, BALA I. The analgesic efficacy of dexmedetomidine as an adjunct to local anesthetics in supraclavicular brachial plexus block:a randomized controlled trial[J]. Anesth Analg,2015,121(6):1655-1660.
    [11] ABDALLAH FW,BRULL R. Facilitatory effects of perineural dexmedetomidine on neuraxial and peripheral nerve block:a systematic review and meta-analysis[J]. Br J Anaesth,2013,110(6):915-925.
    [12] RANCOURT MP,ALBERT NT,CÔTÉM,et al. Posterior tibial nerve sensory blockade duration prolonged by adding dexmedetomidine to ropivacaine[J]. Anesth Analg,2012,115(4):958-962.
    [13] ABDULATIF M, FAWZY M, NASSAR H,et al. The effects of perineural dexmedetomidine on the pharmacodynamic profile of femoral nerve block:a dose-finding randomised, controlled, double-blind study[J]. Anaesthesia,2016;71(10):1177-1185.
    [14] HELAL SM, ESKANDR AM, GABALLAH KM,et al. Effects of perineural administration of dexmedetomidine in combination with bupivacaine in a femoral-sciatic nerve block[J]. Saudi J Anaesth,2016; 10(1):18-24.
    [15] LUNDBLAD M, MARHOFER D, EKSBORG S, et al. Dexmedetomidine as adjunct to ilioinguinal/iliohypogastric nerve blocks for pediatric inguinal hernia repair:an exploratory randomized controlled trial[J]. Paediatr Anaesth,2015, 25(9):897-905.
    [16] ALMARAKBI WA, KAKI AM.Addition of dexmedetomidine to bupivacaine in transversus abdominis plane block potentiates post-operative pain relief among abdominal hysterectomy patients:A prospective randomized controlled trial[J]. Saudi J Anaesth,2014,8(2):161-166.
    [17] KIVIST KT, KALLIO A, NEUVONEN PJ.Pharmacokinetics and pharmacodynamics of transdermal dexmedetomidine[J]. Eur J Clin Pharmacol,1994;46(4):345-349.
    [18] BRUMMETT CM, NORAT MA,PALMISANO JM,et al. Perineural administration of dexmedetomidine in combination with bupivacaine enhances sensory and motor blockade in sciatic nerve block without inducing neurotoxicity in rat[J].Anesthesiology,2008; 109(3):502-511.
    [19] KONAKCI S,ADANIR T,YILMAZ G,et al. The efficacy and neurotoxicity of dexmedetomidine administered via the epidural route[J]. Eur J Anaesthesiol,2008,25(5):403-409.
    [20] ANDERSEN JH, GREVSTAD U, SIEGEL H,et al. Does dexmedetomidine have a perineural mechanism of action when used as an adjuvant to ropivacaine? A paired, blinded, randomized trial in healthy volunteers[J].Anesthesiology,2017;126(1):66-73.
    [21] HARSHAVARDHANA HS.Efficacy of dexmedetomidine compared to clonidine added to ropivacaine in supraclavicular nerve blocks:A prospective, randomized, double blind study[J]. Int J Med Health Sci,2014,(3);127-133.
    [22] SWAMI SS, KENIYA VM, LADI SD,et al. Comparison of dexmedetomidine and clonidine (a2 agonist drugs) as an adjuvant to local anaesthesia in supraclavicular brachial plexus block:A randomised double-blind prospective study[J]. Indian J Anaesth,2012,56(3):243-249.
    [23] SONG JH,SHIM HY,LEE TJ,et al. Comparison of dexmedetomidine and epinephrine as an adjuvant to 1% mepivacaine in brachial plexus block[J]. Korean J Anesthesiol,2014,66(4):283-289.
    [24] MAHENDRU V,TEWARI A,KATYAL S,et al. A comparison of intrathecal dexmedetomidine,clonidine,and fentanyl as adjuvants to hyperbaric bupivacaine for lower limb surgery:A double blind controlled study[J]. J Anaesthesiol Clin Pharmacol,2013,29(4):496-502.
    [25] STARKE K,WAGNER J,SCHVMANN HJ. Adrenergic neuron blockade by clonidine:comparison with guanethidine and local anesthetics[J]. Arch Int Pharmacodyn Ther,1972,195(2):291-308.
    [26] BRUMMETT CM,HONG EK,JANDA AM,et al. Perineural dexmedetomidine added to ropivacaine for sciatic nerve block in rats prolongs the duration of analgesia by blocking the hyperpolarization-activated cation current[J]. Anesthesiology,2011,115(4):836-843.
    [27] BUTTERWORTH JF 5TH,STRICHARTZ GR. The alpha 2-adrenergic agonists clonidine and guanfacine produce tonic and phasic block of conduction in rat sciatic nerve fibers[J]. Anesth Analg,1993,76(2):295-301.
    [28] YOSHITOMI T,KOHJITANI A,MAEDA S,et al. Dexmedetomidine enhances the local anesthetic action of lidocaine via an alpha-2A adrenoceptor[J]. Anesth Analg,2008,107(1):96-101.
    [29] 李金玉,葛东建,祁宾,等. 不同剂量右美托咪定混合罗哌卡因用于臂丛神经阻滞的效果[J]. 中华麻醉学杂志,2013,33(6):711-713.
    [30] MARHOFER P, BRUMMETT CM. Safety and efficiency of dexmedetomidine as adjuvant to local anesthetics[J]. Curr Opin Anaesthesiol,2016;29(5):632-637.
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  • 收稿日期:  2017-06-20
  • 修回日期:  2018-01-20

右美托咪定用于神经阻滞的研究进展

doi: 10.3969/j.issn.1006-0111.2018.04.001
    基金项目:  重庆市科学技术委员会重点项目(cstc2017jcyj BX0043)

摘要: 右美托咪定(Dex)是一种高选择性的α2肾上腺素能受体激动剂,目前作为局麻药的辅助用药在神经阻滞中取得了良好的临床效果,可缩短局麻药的起效时间、延长镇痛时效并减少术后镇痛药的使用,同其他局麻药辅助药物相比,右美托咪定可提供更优的镇痛效果和时程,以及较少的不良反应。

English Abstract

陈琪, 刘兴, 刘红亮. 右美托咪定用于神经阻滞的研究进展[J]. 药学实践与服务, 2018, 36(4): 289-292. doi: 10.3969/j.issn.1006-0111.2018.04.001
引用本文: 陈琪, 刘兴, 刘红亮. 右美托咪定用于神经阻滞的研究进展[J]. 药学实践与服务, 2018, 36(4): 289-292. doi: 10.3969/j.issn.1006-0111.2018.04.001
CHEN Qi, LIU Xing, LIU Hongliang. Research progress of dexmedetomidine in nerve block[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(4): 289-292. doi: 10.3969/j.issn.1006-0111.2018.04.001
Citation: CHEN Qi, LIU Xing, LIU Hongliang. Research progress of dexmedetomidine in nerve block[J]. Journal of Pharmaceutical Practice and Service, 2018, 36(4): 289-292. doi: 10.3969/j.issn.1006-0111.2018.04.001
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