右美托咪啶(Dexmedetomidine, DEX)作为一种新型应用广泛的介导儿茶酚胺作用的高选择性 α2 肾上腺素能受体(Adrenergic receptor, AR)激动剂,在传统镇静作用的基础上兼具镇痛、抗焦虑的作用。近年来关于 DEX 镇痛和器官保护作用的研究报道逐渐增多,围术期辅以 DEX 可减少麻醉镇静药和镇痛药用量,有效保护重要器官功能。针对 DEX在心脏手术的临床应用,器官保护作用以及对临床转归的影响做一综述,为进一步研究右美托咪啶心脏保护作用及围术期应用提供理论依据。该综述介绍了DEX的药理作用和对重要器官保护作用,以及存在的相关机制。趋向深入研究DEX对心脏及其他重要脏器的保护作用及其机制,具有一定临床应用价值,并有望改善心脏手术患者的预后,提高生存率。

Dexmedetomidine(DEX) is a highly selective agonist of alpha-2 adrenergic receptor (AR). DEX has influence on sedation, analgesia and anti-anxiety. It is widely used in perioperative period. In recent years, more and more reports present DEX has analgesic effect. Perioperative period supplemented with DEX can reduce the dosage of narcotic analgesics,prolong the duration of analgesia and sedation, and protect the function of vital organs. In this paper, we summarized application of DEX, organ protection as well as prognosis after heart surgery. In order to further study the supporting heart protection mechanism and provide theoretical basis for perioperative application. This article introduced the pharmacological effects of DEX, protection for the heart and other organs, and the existence of related mechanisms. Furthermore, DEX in-depth research on the heart and other protective effect and its mechanism of important organs, has a certain clinical application value, which is expected to improve the prognosis of patients with cardiac surgery, improve the survival rate.

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