右美托咪定用于丙泊酚闭环靶控手术患者的最新研究进展

The Latest Research Progress of Using Dexmedetomidine in Patients Undergoing Propofol Closed-Loop Target-Controlled Surgery

摘要: 麻醉是确保手术顺利进行的重要环节，然而麻醉过程中若麻醉药物使用不当可给患者带来不良影响，而个体化、精准化麻醉是目前临床研究热点，而精准化麻醉需以全面麻醉深度监测为基础。另外，近年来静脉闭环靶控输注亦成为临床研究观察的热点。闭环输注系统是近年来新提出的麻醉药品输注系统概念，其具有反馈信息控制性能。闭环输注系统的调节点是期望最佳药物药效和预期麻醉深度，通过脑电信号反馈药效进而调整闭环控制输注靶质量浓度。近年来，有研究人员对右美托咪定和丙泊酚在体内的药代动力学过程进行了深入研究，发现两者联合使用时，右美托咪定可以影响丙泊酚的代谢和分布，延长丙泊酚的作用时间，从而增强麻醉效果。同时，丙泊酚也可能对右美托咪定的药代动力学产生一定的影响，两者之间的相互作用需要在临床实践中进行合理的调整和监测。因此本文将就右美托咪定用于丙泊酚闭环靶控手术患者的最新进展进行综述。

Abstract: Anesthesia is an important step to ensure the success of surgery, but if anesthetic drugs are used improperly during the anesthesia process, it can have adverse effects on patients. Individualized and precise anesthesia is currently a hot research topic in clinical studies, and precise anesthesia requires comprehensive anesthesia depth monitoring as a basis. In addition, intravenous closed-loop target-controlled infusion has also become a hot research topic in recent years. The closed-loop infusion system is a new concept of anesthetic drug infusion system proposed in recent years, which has feedback control performance. The regulation point of the closed-loop infusion system is the desired optimal drug effect and the expected anesthesia depth, and the brain electrical signal feedback effect is used to adjust the closed-loop control infusion target quality concentration. In recent years, researchers have conducted in-depth studies on the pharmacokinetic process of dexmedetomidine and propofol in vivo, and found that when used together, dexmedetomidine can affect the metabolism and distribution of propofol, prolonging the action time of propofol and thereby enhancing the anesthetic effect. At the same time, propofol may also have certain effects on the pharmacokinetics of dexmedetomidine, and the interaction between the two needs to be reasonably adjusted and monitored in clinical practice. Therefore, this article will review the latest advances in the use of dexmedetomidine in propofol closed-loop target-controlled surgical patients.