Dexmedetomidine: A review of clinical applications

Abstract

PURPOSE OF REVIEW: The present review serves as an overview update in the diverse uses of the sedative dexmedetomidine. RECENT FINDINGS: Dexmedetomidine is a selective α2 adrenoreceptor agonist that has been described as a useful, safe adjunct in many clinical applications. This paper reviews current clinical uses, mechanism of action, and side effects of dexmedetomidine. The current uses reviewed include sedation in the ICU (adult and pediatric), neurosurgery, pediatric procedural sedation, awake fiber-optic intubation, cardiac surgery, and bariatric surgery. SUMMARY: Dexmedetomidine is a useful medication with many clinical applications. The medication has shown efficacy in decreasing the need for opioids, benzodiazepines, propofol, and other sedative medications. Short-term sedation has been shown to be safe in studies, although hypotension and bradycardia are the most significant side effects. Dexmedetomidine has been used effectively for sedation during pediatric procedures and in the ICU. In order to reduce sympathetic tone during cardiac surgery, a low-dose dexmedetomidine infusion has been utilized. The bariatric surgery population has also been studied with dexmedetomidine because of its adequate sedation and less prevalent respiratory depression when compared with opioid administration. Dexmedetomidine is emerging as an effective therapeutic agent in the management of a wide range of clinical conditions with an efficacious, safe profile. © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins.