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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中图分类号R971+.2；R96 文献标志码A 文章编号1001-0408（2025）15-1947-06

DOI 10.6039/j.issn.1001-0408.2025.15.23

Mechanismand clinical research progressof remifentanil inthepreventionand treatment of emergence agitation

WANG Na1，2 ，DUAN Yongbo².3，XIAO Zhongjie1，2，SONG Yujing1，2， YAN Wenjun²（1. First School of Clinical Medicine，Gansu University of Chinese Medicine，Lanzhou 730099，China;2.Dept.of Anesthesiology，Gansu Provincial Hospital，Lanzhou 7300l3，China；3.First School of Clinical Medicine，Lanzhou University， Lanzhou 730013，China）

ABSTRACTEmergenceagitation（EA）isacommoncomplicationaftergeneralanesthesia，especiallinchildrenand adolescents.Remifentanil，as a short-acting μ -receptor agonist，has become an important drug for the prevention and treatment of EAduetoitsrapidrecoveryandlowriskofrespiratorydepresion.Thisarticlereviewsthemechanismofactionandclinical research progressofremifentanilinthepreventionandtreatmentofEA.Itsmechanismofactioninvolvestheinhibitioof pain signals mediated by traditional μ -receptor activation and potential new mechanism based on neural-endocrine-immune network， includingregulationof microglial inflammatorypathways，andthe modulationofcytokinesandchemokines，etc.Clinical studies haveshownthatremifentanilcansignificantlyshorten therecoverytime，reducetheincidenceofEA，andfurtheroptimizethe analgesiceffectandrecoveryqualitybycombining withother drugs（suchaslocalanesthetics，sedatives，andopioid drugs）.Future researchshouldfurtherexplorethemechanismofactionofremifentanil，optimizeclinicaltreatmentstrategies，andconduclargescaleclinicaltrialstostandardizethedruguseplan，whilepayingattentiontoitslong-termeffectsandthedevelopmentof multimodal treatment plans to promote the further development of EA prevention and treatment plans.

KEYWORDS remifentanil；emergence agitation；neuroimmune mechanisms；clinical applications

苏醒期躁动（emergenceagitation，EA）是全麻后常见的临床表现，其特征是在术后苏醒阶段出现意识混乱、行为亢进和情绪焦虑等症状。（剩余13470字）