The efficacy and neurotoxicity of dexmedetomidine administered via the epidural route

Abstract

We observed that dexmedetomidine does not have motor and sensory effects, but it may have a harmful effect on the myelin sheath when administered via the epidural route.

Dexmedetomidine as an Adjuvant to Levobupivacaine in Ultrasound Guided Supraclavicular Brachial Plexus Block

“…[7,8,9] Its use as an adjuvant in central neuraxial blocks has also been mentioned. [10,11,12,13] Its use in peripheral nerve blocks has recently been described. [14,15,16] However, the reports of its use in supraclavicular brachial plexus block are limited.…”

Ultrasound-Guided Supraclavicular Brachial Plexus Block With or Without Dexmedetomidine as an Adjuvant to 0.5% Levobupivacaine- A Comparative Study

“…10 At clinically effective doses, high selectivity for α2A receptors mediates analgesia, sedation, anxiolysis and lacks respiratory depression. 6, 11 The research done so far shows encouraging results for its use in intravenous sedation (ICU and operative patients), spinal, 12 epidural, 13 caudal anaesthesia 14 and Bier's block. 15 By its effects on spinal α2 receptors, it prolongs analgesia when used with local anaesthetics for neuraxial blocks.…”

Effects of intracisternal dexmedetomidine on cerebral neuronal cells in rat: a preliminary study

“…Additionally, it has been reported that dexmedetomidine added to local anesthetics in intravenous regional anesthesia improved the quality of anaesthesia (5,20) and it could partially prevent neuronal damage in some models of ischemia-induced brain injury (8, 9, 15-17). On the other hand, Konakci et al reported that dexmedetomidine produced moderate or severe demyelinization of myelin sheats in the white matter of spinal cord in rabbit, when it was administered by the epidural route (14). Because dexmedetomidine is a highly lipo- …”

“…Konakci et al were shown in their study that dexmedetomidine produced the moderate or severe demyelinization of myelin sheaths in the white matter of spinal cord, when it was administered by the epidural route. They suggested that this effect could be related to vasoconstriction of the medullary spinal vessels (14). However, they did not evaluate the possible toxic effects of dexmedetomidine on cerebral neuronal cells when it was administered by epidural route.…”

“…On the other hand, it has been shown by Konakci et al. that dexmedetomidine produced moderate or severe demyelinization of myelin sheats in the white matter of spinal cord in rabbit, when it is administered by the epidural route (14), and this effect has been explained by the agent's vasoconstrictive effect on medullar spinal vessels (10). It is known that topical application of dexmedetomidine had vasoconstrictor effects both on cerebral pial arterial and venous vessels (11).…”