右美托咪定对围手术期睡眠影响的研究进展  

Impact of dexmedetomidine on perioperative sleep:a narrative review

作　　者：李妍[1] 王东信[1] Li Yan;Wang Dongxin(Department of Anesthesiology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院麻醉科,北京100034

出　　处：《国际麻醉学与复苏杂志》2024年第10期1083-1087,共5页International Journal of Anesthesiology and Resuscitation

摘　　要：围手术期睡眠障碍普遍存在,并与多种术后不良事件相关,改善围手术期睡眠有助于改善术后结局。右美托咪定是高选择性的α2肾上腺素能受体激动剂,具有抗焦虑和镇静、镇痛作用。文章回顾了右美托咪定对围手术期睡眠影响的研究,发现围手术期应用右美托咪定有助于改善患者睡眠结构、提高睡眠质量,但可能增加心动过缓和低血压的发生;小剂量右美托咪定静脉给药或右美托咪定经鼻给药也可改善围手术期睡眠,而不良事件的风险降低;右美托咪定‑艾司氯胺酮复合给药在改善睡眠方面可能有协同作用,并减少药物相关神经精神症状的发生。右美托咪定在改善围手术期睡眠方面的作用及对临床结局的影响值得进一步探索。Perioperative sleep disorders are common and associated with multiple adverse events.Promoting perioperative sleep may help improve postoperative recovery.Dexmedetomidine is a highly selectiveα2 adrenergic agonist with anxiolytic,sedative,and analgesic effects.This review summarized the effects of dexmedetomidine on perioperative sleep.Recent studies suggest that peri‑operative use of dexmedetomidine not only improves sleep structure and subjective sleep quality,but also increases bradycardia and hy‑potension.Intravenous administration of low‑dose dexmedetomidine or trans‑nasal administration of sedative dose dexmedetomidine may also improve perioperative sleep quality while decrease adverse events.Administration of dexmedetomidine‑esketamine combina‑tion may produce a synergistic effect in improving perioperative sleep quality with less neuropsychiatric symptoms.The impact of dex‑medetomidine in improving perioperative sleep and on clinical outcomes deserves further exploration.

关 键 词：围手术期 睡眠障碍 右美托咪定 艾司氯胺酮 

分 类 号：R614[医药卫生—麻醉学]