Current clinical application of dexmedetomidine for sedation and anesthesia.
10.17085/apm.2017.12.4.306
- Author:
Doo Sik KIM
1
;
Hyo seok NA
;
Ji hyang LEE
;
Young Duck SHIN
;
Jae Kwang SHIM
;
Hye Won SHIN
;
Hyoseok KANG
;
Kyoung Woon JOUNG
Author Information
1. Department of Anesthesiology and Pain Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea. kds0728md@gmail.com
- Publication Type:Review
- Keywords:
Dexmedetomidine;
Procedure;
Regional anesthesia;
Sedation
- MeSH:
Anesthesia*;
Anesthesia, Conduction;
Barbiturates;
Benzodiazepines;
Blood Pressure;
Bradycardia;
Brain;
Critical Illness;
Delirium;
Dexmedetomidine*;
GABAergic Neurons;
Heart;
Histamine Antagonists;
Humans;
Hypnotics and Sedatives;
Hypotension;
Propofol;
Respiratory Insufficiency;
Thoracic Surgery
- From:Anesthesia and Pain Medicine
2017;12(4):306-319
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Many sedatives are used clinically and include benzodiazepines, barbiturates, antihistamines, propofol, and alpha-2-agonist. Benzodiazepines activate GABA neuronal receptors in the brain and present sedating, hypnotic, anxiolytic, amnestic, and anticonvulsant effects, but low analgesic effects. Propofol induce sedative, anxiolytic, and amnestic effects but no analgesic effects. However, risks such as cardiopulmonary instability and hypotension must be considered during administration. Dexmedetomidine is a high selective alpha-2 agonist and has many advantages as a sedative. Patients under dexmedetomidine sedation awaken easily and are more likely to be cooperative. Risk of respiratory depression and cardiopulmonary instability is low as well. Additionally, dexmedetomidine decreases amount of analgesic needed during and after surgery, presenting analgesic effects. Dexmedetomidine also decreases risk of delirium. However, bradycardia may occur and biphasic effects on blood pressure may be observed during beginning of administration. Because of lengthy symptom onset and offset time, physicians should carefully control administration at the beginning and end of dexmedetomidine administration. The purpose of this review is to evaluate the efficacy and availability of dexmedetomidine in various clinical fields including sedation for critically ill patients, regional anesthesia, monitored anesthesia care for some invasive procedures, stabilization of heart in cardiac surgery or endoscopic procedures.
