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A study on conscious sedation with alpha_2 -agonist and alpha_2-antagonist

α_2激动剂和α_2拮抗剂清醒镇静的研究

基本信息

批准号：
08045071
负责人：
YAMASHIRO Mikiko
金额：
$ 2.75万
依托单位：
The Nihon Dental University
依托单位国家：
日本
项目类别：
Grant-in-Aid for international Scientific Research
财政年份：
1996
资助国家：
日本
起止时间：
1996 至 1998
项目状态：
已结题

项目摘要

Clonidine is a prototype of alpha^2-agonist and was originally introduced to clinical practice as an antihypertensive drug. The objective of this study is to evaluate the effects of clonidine as anadjunct in intravenous conscious sedation. We assessed the effects on haemodynamic and adrenergic responses to nociceptive stimuli, sedation and analgesic effects. 20 volunteers received 2 mu g/kg of clonidine intravenously. Constant current, square-wave electric stimuli (duration 20 msec, interval 100 msec, train 10, 5 mA) were delivered as nociceptive stimuli to the median nerve. We measured blood pressure, heart rate(HR) every 5 min, and plasma levels of adrenaline, noradrenaline and cortisol before and 15, 30, 45, 60 and 90 min after clonidine injection, sedative and analgesic effects were measured by visual analogue scale before and 15, 30, 45, 60 and 90 min after drug. HR decreased significantly 0, 20, 30, 50 and 60 minutes after clonidine injection. The maximum decrease in HR was within 10% (8.4%). Systoli pressure(SP) decreased singnificantly 20 minutes later. There was no significant difference from the control at any point in diastolic pressure(DP). The decrease in SP was within 10%, and 2mug/kg of intravenous clonidine did not induce severe hypotension throughout the study in any subject. Clonidine produced significant decrease in adrenaline levels 15 and 60 minutes after intravenous injection. Noradrenaline concentrations significantly decreased 15, 60 and 90 minutes after the injection. Plasma cortisol levels showed significant differences from the control 15, 30, 60 and 90 minutes after clonidine administration. Dry mouth and fatigue or weariness were the most frequent perceptive side effects. 2 mu g/kg of intravenous clonidine did not induce severe bradycardia, hypotension or other serious side effects. it attenuated the adrenergic responses to nociceptive stimuli, and exerted good sedative effect.

可乐定是α2受体激动剂的原型，最初作为一种抗高血压药物引入临床实践。本研究的目的是评价可乐定作为静脉清醒镇静的辅助药物的效果。我们评估了对伤害性刺激、镇静和止痛作用的血流动力学和肾上腺素能反应的影响。20名受试者静脉注射可乐定2微克/公斤。恒流方波电刺激(持续时间20毫秒，间隔100毫秒，序列10，5 mA)作为伤害性刺激传递给正中神经。分别于注射可乐定前及注射可乐定后15、30、45、60、90min测量血压、心率(HR)及血浆肾上腺素、去甲肾上腺素、皮质醇水平，并于用药前及用药后15、30、45、60、90min用视觉模拟评分法评定镇静镇痛效果。注射可乐定后0min、20min、30min、50min、60min时HR显著降低。心率最大下降幅度在10%以内(8.4%)。20分钟后系统压(SP)显著下降。舒张压(DP)在各时间点均与对照组无显著差异。在整个研究过程中，SP的下降幅度在10%以内，静脉注射可乐定2mug/kg在任何受试者中都没有引起严重的低血压。可乐定在静脉注射后15分钟和60分钟时肾上腺素水平显著降低。注射后15分钟、60分钟和90分钟去甲肾上腺素浓度显著降低。可乐定给药后15、30、60、90分钟血浆皮质醇水平与对照组比较差异有统计学意义。口干和疲劳或疲倦是最常见的可察觉副作用。静脉注射可乐定2 mg/kg未出现严重的心动过缓、低血压等严重副作用。可减弱伤害性刺激引起的肾上腺素能反应，具有良好的镇静作用。