右美托咪定联合水合氯醛在新生儿镇静中的 临床应用
Clinical Application of Dexmedetomidine Combined with Chloral Hydrate in Neonatal Sedation
DOI: 10.12677/acm.2026.1641532, PDF,   
作者: 云焕杰*, 涂生芬#：重庆医科大学附属儿童医院麻醉科，儿童发育疾病研究教育部重点实验室，国家儿童健康与疾病临床医学研究中心，儿童发育重大疾病国家国际科技合作基地，重庆
关键词: 右美托咪定；水合氯醛；新生儿；镇静；联合用药；Dexmedetomidine； Chloral Hydrate； Neonatal； Sedation； Drug Combination
摘要: 右美托咪定是一种高选择性α2肾上腺素受体激动剂，通过作用于蓝斑核α2受体及激动内源性促睡眠通路而产生镇静催眠作用。水合氯醛则是一种经典镇静催眠药，能够产生催眠、抗惊厥效应，并可诱导近似生理性的睡眠。目前，右美托咪定与水合氯醛在临床镇静中均有广泛的应用，但由于新生儿在药物代谢、器官功能及血脑屏障通透性等方面与成人存在本质差异，临床镇静过程中的风险较高。右美托咪定经鼻腔给药生物利用度可达65%，在新生儿中具有独特优势；水合氯醛口服或直肠给药后1小时达峰。两药联用可产生协同效应，减少单药用量，降低呼吸抑制等不良反应风险。故本文对右美托咪定联合水合氯醛在新生儿镇静中的应用进行综述。
Abstract: Dexmedetomidine is a highly selective α₂-adrenoceptor agonist that produces sedative and hypnotic effects by acting on the locus coeruleus α2 receptor and activating endogenous sleep-promoting pathways. Chloral hydrate is a traditional sedative-hypnotic agent that can induce hypnosis and anticonvulsant effects, and can induce sleep similar to physiological sleep. Currently, dexmedetomidine and chloral hydrate are widely used in clinical sedation. However, due to significant differences in physiological function, drug metabolism and blood-brain barrier between newborns and adults and children, the risks during clinical sedation are higher. Dexmedetomidine administered intranasally achieves a bioavailability of up to 65%, offering advantages in neonates; chloral hydrate reaches peak concentration 1 hour after oral or rectal administration. The combination of these two drugs can produce synergistic effects, reduce the dosage of individual agents, and lower the risk of adverse reactions such as respiratory depression. Therefore, this article provides a review of the application of dexmedetomidine combined with chloral hydrate in neonatal sedation.
文章引用：云焕杰, 涂生芬. 右美托咪定联合水合氯醛在新生儿镇静中的 临床应用[J]. 临床医学进展, 2026, 16(4): 2778-2785. https://doi.org/10.12677/acm.2026.1641532

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