Abstract:
Dexmedetomidine\'s α-adrenoreceptor agonism has been gaining popularity in the anesthetic room as a sedative-hypnotic and analgesic agent, and with extensive perioperative use rising concern about side effects is necessary. Bradycardia and hypotension are common adverse effects, but there are also several reports of excessive urine output, possibly due to vasopressin secretion and permeability of collecting ducts. Polyuria usually resolves with discontinuation of the drug, and significant morbidity has not been reported. Early identification, removal of the agent, and treatment are imperative to minimize complications - mainly natremia and neurological symptoms. This case report describes a dexmedetomidine-related polyuric syndrome during opioid-free general anesthesia for major head and neck surgery. A nephrogenic mechanism for the clinical effect is proposed and reinforced by analytical data obtained. An intra-operative polyuria approach is also delineated.
摘要:
α-肾上腺素受体激动剂右美托咪定越来越多地用作镇静催眠药和镇痛剂,但是随着这种流行,人们开始担心这种药物的副作用。心动过缓和低血压是常见的不良反应,但是也有一些尿液排出过多的报告,可能是由于血管加压素分泌和血管通透性所致。多尿通常随着停药而消退,和显著的发病率尚未报告。早期识别,移除代理,和治疗是必要的,以尽量减少并发症-主要是贫血和神经症状。该病例报告描述了在无阿片类药物全身麻醉用于主要头颈部手术期间右美托咪定相关的多尿。获得的分析数据加强了我们关于肾源性病因的假设。我们还描述了术中多尿的方法。