Dexmedetomidine Use in General Anaesthesia

Abstract

Dexmedetomidine is a potent and highly selective alpha(2)-adrenoreceptor agonist currently utilized for continuous infusion for sedation/analgesia in the intensive care unit (ICU). Dexmedetomidine offers remarkable pharmacological properties including sedation, anxiolysis, and analgesia with the unique characteristic to cause no respiratory depression. In addition it posses sympatholytic and antinociceptive effects that allow hemodynamic stability during surgical stimulation. Different from most of clinically used anesthetics, dexmedetomidine brings about not only a sedative-hypnotic effect via an action on a single type of receptors, but also an analgesic effect and an autonomic blockade that is beneficial in cardiac risk situations. Several studies have demonstrated its safety, although bradycardia and hypotension are the most predictable and frequent side effects. Dexmedetomidine has shown to consistently reduce opioids, propofol, and benzodiazepines requirements. In the last years it has emerged as an affective therapeutic drug in a wide range of anesthetic management, promising large benefits in the perioperative use. In particular this review focuses on dexmedetomidine utilization in premedication, general surgery, neurosurgery, cardiac surgery, bariatric surgery, and for procedural sedation and awake fiberoptic intubation. In all these fields dexmedetomidine has demonstrated to be an efficacious and safe adjuvant to other sedative and anesthetic medications.

Target‑controlled infusion of propofol and remifentanil combined with dexmedetomidine reduces functional endoscopic sinus surgery bleeding

“…As an anesthetic adjuvant, dexmedetomidine may reduce the dosage of opioids and propofol (31). In the present study, compared with propofol and remifentanil alone, dexmedetomidine was able to significantly decrease the mean infusion rate of propofol (101.5±8. )…”

Pre-anesthetic sedative effect of dexmedetomidine in laparoscopic cholecystectomy performed under general anesthesia

“…DEX, even at a significantly high concentration, does not cause respiratory depression [10,11]. In our study, 2 patients Previous studies reported that use of DEX prior to general anesthesia lowered the required dose of thiopental and propofol by 37% and 80%, respectively [12,13].…”

The effect of dexmedetomidine against oxidative and tubular damage induced by renal ischemia reperfusion in rats

“…a2-adrenoreceptor agonists are also expected to increase the release of atrial natriuretic peptide resulting in natriuresis. 6 The purpose of this experimental study was to evaluate the biochemical and histologic effects of dexmedetomidine on kidney IR injury in rats.…”