【摘要】 艾司氯胺酮是氯胺酮的右旋异构体，具有药效强、起效快、副作用少等优点，在镇静、镇痛、抗抑郁等方面有着广阔的应用前景。右美托咪定已广泛用于围手术期及重症监护室程序化镇静，其具有抗炎、镇痛、抗焦虑等作用，且对呼吸和血流动力学的影响小。艾司氯胺酮与右美托咪定复合使用时具有协同效应，减少用药剂量的同时提供更强的镇静、镇痛效果及更稳定的血流动力学，降低精神副作用。本文根据二者的药理学机制及临床应用情况加以综述，以期为麻醉医生提供更多的用药选择。

    【关键词】 艾司氯胺酮 右美托咪定 镇静 镇痛 抗抑郁

    Research Progress on the Application of Ketamine Combined with Dexmedetomidine

    [Abstract] Esketamine is the dextroisomer of Ketamine， which has the advantages of strong drug effect， fast onset and few side effects， and has broad application prospects in sedation， analgesia， antidepressant， and other fields. Dexmedetomidine has been widely used for programmed sedation in perioperative and intensive care units. It has anti-inflammatory， analgesic and anti anxiety effects， and has little impact on respiration and hemodynamics. The combination of Esketamine and Dexmedetomidine has a synergistic effect， which can reduce the dosage and provide stronger sedative and analgesic effects， more stable hemodynamics and reduce mental side effects. This article reviews the pharmacological mechanisms and clinical applications of both in order to provide anesthesiologists with more medication options. ......