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      1. 10/2/5:25:01

        時間:2024-09-25 22:16:06 醫學畢業論文 我要投稿
        • 相關推薦

        10/2/20075:25:01

        畢業論文

        M53.doc 1 10/2/20075:25:01 PM
        Comparative clinical pharmacology of dexmedetomidine
        Akira Asada, MD
        Professor and Chair
        Department of Anesthesiology and Intensive Care Medicine
        Osaka City University Medical School
        Drugs used for sedation include analgesics such as opioids, sedatives such
        as propofol and midazolam, or neuroleptics. All of these agents have
        adverse consequences, such as respiratory depression, delirium, lack of
        orientation and cooperation, hypotension, tolerance and abuse potential. A
        new agent, dexmedetomidine was approved for sedation in the intensive
        care unit in Japan in 2004. Dexmedetomidine is an alpha-2 agonist that acts
        on the locus ceruleus/norepinephrine axis, providing non-REM sleep,
        sedation, anxiolysis without respiratory depression. The agent produces
        both sedative and analgesic properties through the effects on the alpha-2
        receptors in the brain and spinal cord.
        Many papers have been published to show the neuroprotective role of the
        agent to improve neurological outcome. The agent produced a
        dose-dependent reduction in neuronal injury provoked by oxygen-glucose
        deprivation in glial-neuronal cultures derived from rats. The agent usually
        causes a decrease in heart rate, and blood pressure as a result of a centrally
        mediated reduction in sympathetic tone. The reduction may have a
        beneficial effect on the heart.
        The agent can facilitate the extubation process by attenuating the
        hemodynamic responses without respiratory depression. Another novel
        advantage of the agent is to make a sedated patient aroused easily to
        demonstrate normal cognitive ability. Therefore, a neurological assessment
        could be done whenever required. The duration for mechanical ventilation
        and days for hospital stay would be reduced by the agent.
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