Dexmedetomidine Pharmacodynamics: Part I

Hsu, Yung Wei; Cortínez, Luis Ignacio; Robertson, Kerri M.; Keifer, John C.; Sum-Ping, Sam T.; Moretti, Eugene W.; Young, Christopher C.; Wright, David; MacLeod, David B.; Somma, Jacques

doi:10.1097/00000542-200411000-00005

Cited by 381 publications

(100 citation statements)

References 5 publications

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“…Moreover, dexmedetomidine has been known to induce sleep characteristics similar to physiological sleep [9, 10], and to be less associated with sleep apnea/hypopnea and respiratory depression [10]. In contrast, despite the advantages of propofol, such as rapid onset, short duration, and clear recovery, it has been known to cause respiratory depression, which can be exacerbated when coadministered with opioid [11, 12].…”

Section: Introductionmentioning

confidence: 99%

Comparison of upper airway patency in patients with mild obstructive sleep apnea during dexmedetomidine or propofol sedation: a prospective, randomized, controlled trial

et al. 2018

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BackgroundIn addition to propofol, dexmedetomidine is a suitable alternative for intraoperative sedation in procedures requiring regional anesthesia. To date, however, little is known about the influences of each drug on upper airway patency. Accordingly, the authors investigated differences between dexmedetomidine and propofol sedation in the occurrence of upper airway obstruction and requirements for airway intervention in patients with mild obstructive sleep apnea.MethodsPatients with an apnea/hypopnea index of 5–14/h according to Watch-PAT 200 analysis were enrolled in this study. Spinal anesthesia was routinely performed for surgery. Intraoperative sedation was initiated using either dexmedetomidine or propofol infusion at a level of modified observer’s assessment of alertness/sedation scale 3. The primary outcome was the proportion of patients exhibiting signs of upper airway obstruction. A sign of upper airway obstruction was defined as no detection of end-tidal carbon dioxide for at least 10 s despite respiratory efforts.ResultsA total of 50 patients were included in the final analysis (dexmedetomidine [n = 26]; propofol [n = 24]). During the intraoperative sedation period, there was a significantly lower proportion of patients exhibiting signs of upper airway obstruction in the dexmedetomidine group than in the propofol group (11.5% vs. 41.7%, P = 0.035). An artificial airway was inserted in 1 patients (3.8%) and 5 patient (20.8%) in the dexmedetomidine and propofol groups, respectively (P = 0.093).ConclusionDexmedetomidine sedation was associated with a lower incidence of upper airway obstruction than propofol sedation in patients with mild obstructive sleep apnea.Trial registration numberClinical trials.gov (NCT02993718): Retrospectively registered.

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Section: Introductionmentioning

confidence: 99%

Comparison of upper airway patency in patients with mild obstructive sleep apnea during dexmedetomidine or propofol sedation: a prospective, randomized, controlled trial

et al. 2018

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“…We considered the use of dexmedetomidine for sedation because of its unique sedative properties. Dexmedetomidine has a favorable pharmacological profile that can provide patient comfort, sparing respiratory depression even at large doses [8], and is potentially an ideal sedative for this procedure. Although there are concerns with hypotension and bradycardia, it has a relatively stable hemodynamic profile [9].…”

Section: Discussionmentioning

confidence: 99%

Epidural anesthesia with intravenous dexmedetomidine sedation in the successful anesthetic management of MRI-guided focused ultrasound ablation of early prostatic cancer

Ip-Yam

2011

J Anesth

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We report on five patients who underwent MRI-guided focused ultrasound ablation of prostatic cancer under epidural anesthesia with intravenous dexmedetomidine sedation. This pioneering procedure requires an immobile therapeutic field with adequate sedation and analgesia provided to the patients. Duration of the procedure is longer compared to diagnostic MRI scans. In combination with epidural anesthesia, dexmedetomidine was used to provide moderate levels of sedation without causing respiratory depression or hemodynamic instability, and was useful in preventing shivering. The pharmacological properties of dexmedetomidine contribute to make this technique safe and effective.

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“…It is preferable to use anesthetic agents that maintain spontaneous respiration and have minimal negative hemodynamic effects, such as dexmedetomidine or ketamine. When given in therapeutic doses, dexmedetomidine avoids respiratory depression 8 and is an effective sedative for noninvasive procedures. It has successfully been used for pediatric sedation in CT scans.…”

Section: Airway Obstructionmentioning

confidence: 99%

Pediatric Malignancies and Anesthesia in Out-of-OR Locations

Iravani

2009

International Anesthesiology Clinics

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Dexmedetomidine Pharmacodynamics: Part I

Abstract: In comparison with remifentanil, dexmedetomidine infusions (1) did not result in clinically significant respiratory depression, (2) decreased rather than increased the apnea/hypopnea index, and (3) exhibited some similarity with natural sleep.

Cited by 381 publications

References 5 publications

Comparison of upper airway patency in patients with mild obstructive sleep apnea during dexmedetomidine or propofol sedation: a prospective, randomized, controlled trial

Comparison of upper airway patency in patients with mild obstructive sleep apnea during dexmedetomidine or propofol sedation: a prospective, randomized, controlled trial

Epidural anesthesia with intravenous dexmedetomidine sedation in the successful anesthetic management of MRI-guided focused ultrasound ablation of early prostatic cancer

Pediatric Malignancies and Anesthesia in Out-of-OR Locations

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