High-dose dexmedetomidine increases the opioid-free interval and decreases opioid requirement after tonsillectomy in children

Effective Dose of Intravenous Dexmedetomidine to Prolong the Analgesic Duration of Interscalene Brachial Plexus Block

“…8,21 A large number of studies were performed with IV DEX doses ranging from 0.25 to 1.0 μg/kg, 7,9,11 but higher doses up to 2.0 μg/kg had also been used safely in a number of studies with or without nerve blockade. 10,22,23 Moreover, it is frequently observed that systemic DEX produces relatively shorter duration of analgesia than the same dose given via perineural route. 8,9 In this regard, we selected 3 different IV DEX doses of 0.5, 1.0, and 2.0 μg/kg 10,11,17 to further assess whether the duration of analgesia is prolonged incrementally with increasing doses of IV DEX after single-shot ISBPB.…”

(463) Dexmedetomidine as an adjuvant to analgesic strategy during vaso-occlusive episodes in adolescents with sickle cell disease

“…Reasons to initiate dexmedetomidine included high opioid requirements and development of undesirable side effects, pain unresponsive to escalating doses of opioid, and the clinical impression that in part, opioid-induced hyperalgesia was contributing to patient's pain. Given previous reports that dexmedetomidine facilitates opioid weaning 15,16 and has profound analgesic and sedative effects 12,14 , a decision to initiate dexmedetomidine was made. As suggested by Figure 1, daily oral morphine-equivalent intake was markedly reduced after the initiation of dexmedetomidine.…”

“…Dexmedetomidine decreases opioid consumption and pain intensity 12,14 , and in settings where patients are on high-dose opioids, dexmedetomidine halts escalation of opioid intake and facilitates opioid weaning 15,16 . There are a few reported cases of dexmedetomidine use in SCD patients in emergency rooms and during the perioperative period 17,18 .…”

Acute Postoperative Pain Management in Infants and Children

“…23 Dexmedetomidine at doses of 0.75 to 4 mg/kg with or without an infusion (0.7 mg/kg/h) have been studied in tonsillectomy patients. [24][25][26] While prolonging the opioid-free interval, decreasing emergence agitation postoperatively, or both, the higher doses studied also prolonged postanesthesia care unit stay.…”