摘要：

Dexmedetomidine,a medetomidine D-isomer,is an α2-adrenoceptor agonist with protent sedetation,analgesia and antianxiety effects.It can reduce sympathetic nerve reflex induced by operation and anesthesia,stabilize hemodynamic condition,and exert no inhibition of central respiratory system.Intravenous injection of dexmedetomidine is a commonly used route of administration,mainly for perioperative anesthesia and ICU sedation.Unfortunately,intravenous injection of dexmedetomide is invasive,thus it is not recommended for children.Compared with intravenous medication,non-intravenous use indicates slow but stable onset and wider range of safety,which has good anesthetic effect in perioperative patients or those outside the operating room,especially pediatric patients.Dexmedetomidine by nasal dripping is absorbed into the blood through nasal mucosa,which has immediate effect and high bioavailability.Colorless and tasteless dexmedetomidine provides less nasal mucosa irritation and has good tolerance.This article aims to update and review the safety and effectiveness of intranasal dexmedetomidine in pediatric general anaesthesia.%右美托咪定是美托咪定的右旋异构体,是一种高选择性α2肾上腺素能受体激动剂,具有较强的镇静,镇痛,抗焦虑作用.右美托咪定可减少手术与麻醉引起的交感神经反射,维持血流动力学稳定,且对呼吸中枢无抑制作用.静脉注射是右美托咪定常用的给药途径,主要用于围术期手术麻醉和监护室镇静,但属于有创性操作,不提倡用于小儿.与静脉注射相比,右美托咪定非静脉途径用药起效缓慢平稳,安全范围广,用于围手术期镇静或手术室外的麻醉,具有良好效果,特别适用于小儿患者.右美托咪定经鼻滴注可通过鼻腔黏膜吸收入血,药物起效速度相对较快,生物利用率高.右美托咪定具有无色,无味,对鼻腔黏膜刺激性低,小儿耐受性好的特点.该文对右美托咪定滴鼻在小儿麻醉中应用的安全性,有效性作一综述.

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