CAJ | 학술논문

背景右美托咪定(dexmedetomidine,Dex)目前主要用于全身麻醉的辅助用药、手术前镇静及手术后的镇痛等,但其在产科的应用超出了以上范围. 目的对Dex与产科有关的药理学研究进展及在产科麻醉中的应用进行介绍. 内容动物实验研究证实Dex可以加强子宫平滑肌的收缩;胎盘通过率较低;还具有围手术期脑保护作用,并且不会增加产妇反流误吸的风险.现阶段Dex在产科麻醉的应用仅见个案报道,多应用于一些合并有严重心血管疾病或有椎管内麻醉禁忌证的产妇.Dex可用于产妇纤维支气管镜清醒插管、全麻诱导、分娩镇痛、抗寒战等,并且对新生儿的影响轻微. 趋向 Dex因其稳定的血流动力学、轻微的呼吸抑制、可唤醒的镇静、同时还具有镇痛作用,使其在产科麻醉中应用前景十分广阔;但是由于缺少大样本的Dex人体研究报告,现阶段Dex在产科麻醉中的应用还需慎重.
배경 우미탁미정(dexmedetomidine,Dex)목전주요용우전신마취적보조용약、수술전진정급수술후적진통등,단기재산과적응용초출료이상범위. 목적 대Dex여산과유관적약이학연구진전급재산과마취중적응용진행개소. 내용 동물실험연구증실Dex가이가강자궁평활기적수축;태반통과솔교저;환구유위수술기뇌보호작용,병차불회증가산부반류오흡적풍험.현계단Dex재산과마취적응용부견개안보도,다응용우일사합병유엄중심혈관질병혹유추관내마취금기증적산부.Dex가용우산부섬유지기관경청성삽관、전마유도、분면진통、항한전등,병차대신생인적영향경미. 추향 Dex인기은정적혈류동역학、경미적호흡억제、가환성적진정、동시환구유진통작용,사기재산과마취중응용전경십분엄활;단시유우결소대양본적Dex인체연구보고,현계단Dex재산과마취중적응용환수신중.
Background Currently, dexmedetomidine (Dex) is mainly used as an adjuvant drug in general anesthesia, sedation at preoperative and analgesia in post-operation, whereas its application in obstetrics is off-label.Objective To present the pharmacological properties of Dex and its use in obstetric anesthesia.Content Dex can strengthen the contraction of uterine smooth muscle, while its rate through the placenta is low, Dex has cerebral protective effect in perioperation.Furthermore, Dex do not increase the risk of regurgitation and aspiration of maternal.At present, the reported obstetric anesthesia applications of Dex are individual cases, and Dex was only used in some patients with severe cardiovascular disease or contraindication of intraspinal anesthesia.Dex can be used for maternal bronchoscopy awake intubation, general anesthesia induction, analgesia and prevent postanesthetic shivering.Furthermore, the impact of Dex on the newborn is slight.Trend Dex has stable hemodynamics, mild respiratory depression, arousal sedation effects, and analgesic effects, which make its application prospects in obstetric anesthesia is very broad.Due to the lack of large sample studies of Dex used in human, application of Dex in obstetric anesthesia should be careful at present.