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瑞芬太尼防治苏醒期躁动的作用机制及临床研究进展
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| 篇名： | 瑞芬太尼防治苏醒期躁动的作用机制及临床研究进展 |
| TITLE： | Mechanism and clinical research progress of remifentanil in the prevention and treatment of emergence agitation |
| 摘要： | 苏醒期躁动（EA）是全麻术后常见的并发症，尤其在儿童和青少年中发病率较高。瑞芬太尼作为一种超短效μ受体激动剂，因具有快速苏醒和低呼吸抑制风险的特点，成为防治EA的重要药物。本文综述了瑞芬太尼防治EA的作用机制与临床研究进展，发现其作用机制涉及传统的μ受体激活机制和基于神经-内分泌-免疫网络的潜在新机制（包括小胶质细胞炎症通路的调控、细胞因子与趋化因子的调节等）。临床研究表明，瑞芬太尼可显著缩短苏醒时间、降低EA发生率，并可通过与其他药物（如局麻药、镇静药、阿片类药物）联合应用，进一步优化镇痛效果和苏醒质量。未来研究应进一步探索瑞芬太尼的作用机制，优化临床治疗策略，并开展大规模临床试验以标准化用药方案，同时还应关注该药的远期效果，发展多模式治疗方案，以推动EA防治方案的进一步发展。 |
| ABSTRACT： | Emergence agitation （EA） is a common complication after general anesthesia， especially in children and adolescents. Remifentanil， as a short-acting μ-receptor agonist， has become an important drug for the prevention and treatment of EA due to its rapid recovery and low risk of respiratory depression. This article reviews the mechanism of action and clinical research progress of remifentanil in the prevention and treatment of EA. Its mechanism of action involves the inhibition of pain signals mediated by traditional μ-receptor activation and potential new mechanism based on neural-endocrine-immune network， including regulation of microglial inflammatory pathways， and the modulation of cytokines and chemokines，etc. Clinical studies have shown that remifentanil can significantly shorten the recovery time， reduce the incidence of EA， and further optimize the analgesic effect and recovery quality by combining with other drugs （such as local anesthetics， sedatives， and opioid drugs）. Future research should further explore the mechanism of action of remifentanil， optimize clinical treatment strategies， and conduct large- scale clinical trials to standardize the drug use plan， while paying attention to its long-term effects and the development of multimodal treatment plans to promote the further development of EA prevention and treatment plans. |
| 期刊： | 2025年第36卷第15期 |
| 作者： | 王娜；段永博；肖中杰；宋昱静；阎文军 |
| AUTHORS： | WANG Na，DUAN Yongbo，XIAO Zhongjie，SONG Yujing，YAN Wenjun |
| 关键字： | 瑞芬太尼；苏醒期躁动；神经免疫机制；临床应用 |
| KEYWORDS： | remifentanil； emergence agitation； neuroimmune mechanisms； clinical applications |
| 阅读数： | 17 次 |
| 本月下载数： | 0 次 |
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