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Dexmedetomidine in anesthesiology

BACKGROUND AND OBJECTIVES: Dexmedetomidine is a new alpha2-adrenergic agonist with a selectivity ratio of 1600:1 (alpha2:alpha1). It has important sedative and analgesic effects, good hemodynamic control at stress situations and may, by itself, induce anesthesia. This drug has been used to promote postoperative and intensive care sedation and analgesia. Due to such properties, dexmedetomidine has recently become a co adjuvant drug for anesthesia. So, this is a review of the literature about dexmedetomidine in anesthesia. CONTENTS: Major studies on dexmedetomidine in Anesthesiology are presented, both as premedication and during anesthesia. Action mechanisms of alpha2-adrenergic agonists and dexmedetomidine pharmacokinetic and pharmacodynamic properties are also reviewed in this paper. CONCLUSIONS: Dexmedetomidine premedication, infusion during anesthesia or in the postoperative period improves hemodynamic stability. Anesthetic consumption is decreased during anesthesia. Patients sedated with dexmedetomidine may awake, when requested and become cooperative. Even high dexmedetomidine doses do not cause respiratory depression. Bradycardia is a frequent side effect which may be minimized by slow drug infusion. So, dexmedetomidine is an important additional resource to anesthetic practice that may be used in different patients and surgical procedures.

ANALGESICS


Sociedade Brasileira de Anestesiologia R. Professor Alfredo Gomes, 36, 22251-080 Botafogo RJ Brasil, Tel: +55 21 2537-8100, Fax: +55 21 2537-8188 - Campinas - SP - Brazil
E-mail: bjan@sbahq.org