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Alpha2-Agonisten in der Anästhesiologie

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Zusammenfassung

α2-Agonisten zogen in den letzten Jahren wegen ihrer sedativ-hypnotischen, analgetischen und vegetativ dämpfenden Eigenschaften in der klinischen Anästhesie große Aufmerksamkeit auf sich. Im Rahmen der perioperativen Anwendung von Clonidin als Antihypertensivum fiel auf, dass sich der Bedarf von Hypnotika und Analgetika deutlich verringerte, bei gleichzeitig verbesserter hämodynamischer und sympathoadrenerger Stabilität. In der Intensivmedizin ermöglicht die Anwendung von Dexmedetomidin die Toleranz von Beatmung und invasiven Zugängen bei guter Erweckbarkeit und beugt der Entwicklung eines Delirs vor.

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Literatur

  1. Asano T, Dohi S, Ohta S, Shimonaka H, Iida H (2000) Antinociception by epidural and systemic alpha(2)-adrenoceptor agonists and their binding affinity in rat spinal cord and brain. Anesth Analg 90:400–407

    Article  CAS  PubMed  Google Scholar 

  2. Barr J, Fraser GL, Puntillo K et al (2013) Clinical practice guidelines for the management of pain, agitation, and delirium in adult patients in the intensive care unit. Crit Care Med 41:263–306

    Article  PubMed  Google Scholar 

  3. Bergese SD, Candiotti KA, Bokesch PM et al (2010) A Phase IIIb, randomized, double-blind, placebo-controlled, multicenter study evaluating the safety and efficacy of dexmedetomidine for sedation during awake fiberoptic intubation. Am J Ther 17:586–595

    Article  PubMed  Google Scholar 

  4. Blaudszun G, Lysakowski C, Elia N et al (2012) Effect of perioperative systemic α2 agonists on postoperative morphine consumption and pain intensity: systematic review and meta-analysis of randomized controlled trials. Anesthesiology 111:1312–1322

    Article  CAS  Google Scholar 

  5. Bock M, Kunz P, Schreckenberger R et al (2002) Comparison of caudal and intravenous clonidine in the prevention of agitation after sevoflurane in children. Br J Anaesth 88:790–796

    Article  CAS  PubMed  Google Scholar 

  6. Brosda J, Jantschak F, Pertz HH (2014) α2-Adrenoceptors are targets for antipsychotic drugs. Psychopharmacology (Berl) 231:801–812

    Article  CAS  Google Scholar 

  7. Candiotti KA, Bergese SD, Bokesch PM et al (2010) Monitored anesthesia care with dexmedetomidine: a prospective, randomized, double-blind, multicenter trial. Anesth Analg 110:47–56

    Article  CAS  PubMed  Google Scholar 

  8. Dahmani S, Brasher C, Stany I et al (2010) Premedication with clonidine is superior to benzodiazepines. A meta analysis of published studies. Acta Anaesthesiol Scand 54:397–402

    Article  CAS  PubMed  Google Scholar 

  9. Devereaux PJ, Sessler D, Leslie K et al. for the POISE-2 Investigators (2014) Clonidine in patients undergoing noncardiac surgery. N Engl J Med 370:1504–1513

    Google Scholar 

  10. Elia N, Culebras X, Mazza C, Schiffer E, Tramèr MR (2008) Clonidine as an adjuvant to intrathecal local anesthetics for surgery: systematic review of randomized trials. Reg Anesth Pain Med 33:159–167

    PubMed  CAS  Google Scholar 

  11. El-Kerdawy HM, Zalingen EE, Bovill JG (2000) The influence of the alpha2-adrenoceptor agonist, clonidine, on the EEG and on the MAC of isoflurane. Eur J Anaesthesiol 17:105–110

    PubMed  CAS  Google Scholar 

  12. European Medicines Agency (2011) Anhang I: Zusammenfassung der Merkmale des Arzneimittels [Dexdor 100 Mikrogramm/ml]. 4. Klinische Angaben. http://www.ema.europa.eu/docs/de_DE/document_library/EPAR_-_Product_Information/human/002268/WC500115631.pdf

  13. Gerlach AT, Murphy CV, Dasta JF (2009) An updated focused review of dexmedetomidine in adults. Ann Pharmacother 43:2064–2074

    Article  CAS  PubMed  Google Scholar 

  14. Gowing L, Ali R, White J (2006) Opioid antagonists under heavy sedation or anaesthesia for opioid withdrawal. Cochrane Database Syst Rev 19, CD002022

    Google Scholar 

  15. Gyires K, Zádori ZS, Török T, Mátyus P (2009) Alpha(2)-Adrenoceptor subtypes-mediated physiological, pharmacological actions. Neurochem Int 55:447–453

    Article  CAS  PubMed  Google Scholar 

  16. Huupponen E, Maksimow A, Lapinlampi P et al (2008) Electroencephalogram spindle activity during dexmedetomidine sedation and physiological sleep. Acta Anaesthesiol Scand 52:289–294

    Article  CAS  PubMed  Google Scholar 

  17. Jakob SM, Ruokonen E, Grounds RM et al (2012) Dexmedetomidine vs midazolam or propofol for sedation during prolonged mechanical ventilation: two randomized controlled trials. JAMA 307:1151–1160

    Article  CAS  PubMed  Google Scholar 

  18. Kable JW, Murrin LC, Bylund DB (2000) In vivo gene modification elucidates subtype-specific functions of alpha(2)-adrenergic receptors. J Pharmacol Exp Ther 293:1–7

    PubMed  CAS  Google Scholar 

  19. Kita T, Kagawa K, Mammoto T et al (2000) Supraspinal, not spinal, alpha(2) adrenoceptors are involved in the anesthetic-sparing and hemodynamic-stabilizing effects of systemic clonidine in rats. Anesth Analg 90:722–726

    Article  CAS  PubMed  Google Scholar 

  20. Klein SM, Nielsen KC (2003) Brachial plexus blocks: infusions and other mechanisms to provide prolonged analgesia. Curr Opin Anaesthesiol 16:393–399

    PubMed  Google Scholar 

  21. Maze M, Masahiko F (2000) α2-Adrenoceptors in pain modulation (editorial). Anesthesiology 92:934–936

    Article  CAS  PubMed  Google Scholar 

  22. Mantz J, Josserand J, Hamada S (2011) Dexmedetomidine: new insights. Eur J Anaesthesiol 28:3–6

    Article  CAS  PubMed  Google Scholar 

  23. Pandharipande PP, Pun BT, Herr DL et al (2007) Effect of sedation with dexmedetomidine vs lorazepam on acute brain dysfunction in mechanically ventilated patients: the MENDS randomized controlled trial. JAMA 298:2644–2653

    Article  CAS  PubMed  Google Scholar 

  24. Pasin L, Landoni G, Nardelli P et al (2014) Dexmedetomidine reduces the risk of delirium, agitation and confusion in critically Ill patients: a meta-analysis of randomized controlled trials. J Cardiothorac Vasc Anesth 28:1459–1466

    Article  CAS  PubMed  Google Scholar 

  25. Peng K, Liu HY, Wu SR et al (2015) Effects of combining dexmedetomidine and opioids for postoperative intravenous patient-controlled analgesia: a systematic review and meta-analysis. Clin J Pain [Epub Vor Druck]

    Article  PubMed  Google Scholar 

  26. Piper SN, Maleck WH, Boldt J et al (2000) A comparison of urapidil, clonidine, meperidine and placebo in preventing postanesthetic shivering. Anesth Analg 90:954–957

    Article  CAS  PubMed  Google Scholar 

  27. Riker RR, Shehabi Y, Bokesch PM et al (2009) Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial. JAMA 301:489–499

    Article  CAS  PubMed  Google Scholar 

  28. Schnabel A, Meyer-Frießem CH, Reichl SU et al (2013) Is intraoperative dexmedetomidine a new option for postoperative pain treatment? A meta-analysis of randomized controlled trials. Pain 154:1140–1149

    Article  CAS  PubMed  Google Scholar 

  29. Segal IS, Vickery RG, Walton JK, Doze VA, Maze M (1988) Dexmedetomidine diminishes halothane anesthetic requirements in rats through a postsynaptic α2 adrenergic receptor. Anesthesiology 69:818823

    Google Scholar 

  30. Snapir A, Posti J, Kentala E et al (2006) Effects of low and high plasma concentrations of dexmedetomidine on myocardial perfusion and cardiac function in healthy male subjects. Anesthesiology 105:902–910

    Article  CAS  PubMed  Google Scholar 

  31. Talke P, Chen R, Thomas B et al (2000) The hemodynamic and adrenergic effects of perioperative dexmedetomidine infusion after vascular surgery. Anesth Analg 90:834–839

    Article  CAS  PubMed  Google Scholar 

  32. Venn RM, Hell J, Grounds RM (2000) Respiratory effects of dexmedetomidine in the surgical patient requiring intensive care. Crit Care 4:302–308

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Busley, R. (2016). Alpha2-Agonisten in der Anästhesiologie. In: Rossaint, R., Werner, C., Zwißler, B. (eds) Die Anästhesiologie. Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45539-5_17-1

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  • DOI: https://doi.org/10.1007/978-3-662-45539-5_17-1

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  • Print ISBN: 978-3-662-45539-5

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