Alpha-2 agonists in neuroanesthesia
| Autor: | Victor S.B. Jorden, Alex Bekker |
|---|---|
| Rok vydání: | 2004 |
| Předmět: |
Drug
business.industry Sedation media_common.quotation_subject Central nervous system Neuroprotection Clonidine Anesthesiology and Pain Medicine medicine.anatomical_structure Anesthesia Anesthetic medicine Alpha-2 adrenergic receptor medicine.symptom Dexmedetomidine business media_common medicine.drug |
| Zdroj: | Seminars in Anesthesia, Perioperative Medicine and Pain. 23:181-191 |
| ISSN: | 0277-0326 |
| DOI: | 10.1053/j.sane.2004.01.010 |
| Popis: | The primary action of alpha-2 adrenoreceptor agonists is the inhibition of norepinephrine release that causes an attenuation of excitation in the central nervous system (CNS). Activation of these receptors in the CNS produces dose-dependent sedation, anxiolysis, and analgesia (involving spinal and supraspinal sites) without respiratory depression. Alpha-2 agonists have also reduced anesthetic requirements and afford hemodynamic stability during intraoperative period. These clinical characteristics make it a potentially attractive adjunct for neuroanesthesia. When a new drug is introduced into neuroanesthesia practice, however, several considerations must be addressed. A principal concern is a drug’s ability to preserve intracranial homeostasis, to offer a smooth and hemodynamically stable induction, a compatibility with neurophysiologic monitoring, and to assure rapid emergence to a level of consciousness that permits neurologic assessment in the operating room. Additional desirable properties include a reduction of cerebral blood volume, which would minimize brain retraction during the operation, an optimization of oxygen supply/demand relationship, and neuroprotection. This review will discuss pharmacology, current clinical applications, central nervous system effects, and the therapeutic role of clonidine and dexmedetomidine (DEX) (currently available alpha-2 agonists for use in anesthetic practice) in patients undergoing neurosurgical procedures. |
| Databáze: | OpenAIRE |
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