右美托咪定在老年麻醉中的应用及进展

摘要

Dexmedetomidine (Dex) is a potent and highly selective α2-adrenergic receptor agonist. Clinical practice has confirmed that Dex has a unique analgesic, sedative and anti-sympathetic effect, which can reduce the amount of analgesia anesthetic , optimize intraoperative hemodynamic parameters, reduce the incidence of myo-cardial ischemia, and have minor respiratory inhibition. It has a unique advantage in stabilizing perioperative circulation, neuroprotection and organ protection. In this article, we reviewed the application of Dex in the elder patients under different conditions, including the induction of general anesthesia, assistant intrathecal anesthesia and monitoring anesthesia care (MAC) in the various surgery and postoperative analgesia.%盐酸右美托咪定(dexmedetomidine,Dex)是一高效、高选择性的α2-肾上腺素能受体激动剂.临床试验证实Dex具有独特的镇痛、镇静、抗交感神经作用,能减少麻醉中镇痛药用量、优化术中血流动力学参数以及降低心肌缺血的发生率,同时对呼吸系统抑制轻微,在稳定循环、进行神经、器官保护方面有独特的优势,尤其适用于老年患者.本文针对Dex在老年患者不同条件下的应用进行综述,包括Dex用于老年患者的全麻诱导、辅助椎管内麻醉、各种手术操作中监护麻醉(MAC)以及术后镇痛等.