Clinical application of dexmedetomidine
TLDR
The purpose of this review is to discuss dexmedetomidine in terms of its pharmacokinetics and pharmacodynamics, and to focus on its various clinical applications.Abstract:
Dexmedetomidine is a highly selective and potent alpha2-adrenoreceptor (AR) agonist offering dosedependent sedation, anxiolysis and analgesia. It is a relatively new drug, approved for sedation for up to 24 hours in mechanically ventilated post-cardiac surgery patients. Yet, because of its unique drug profile, it has been increasingly studied and used in various clinical settings, albeit off label, with promising results. The purpose of this review is to discuss dexmedetomidine in terms of its pharmacokinetics and pharmacodynamics, and to focus on its various clinical applications. A PubMed search, using the keyword “dexmedetomidine”, identified approximately 1,000 articles, the earliest being animal studies published in 1988.read more
Citations
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Dexmedetomidine in current anaesthesia practice- a review.
Shagufta Naaz,Erum Ozair +1 more
TL;DR: Dexmedetomidine is an alpha 2 adrenergic receptor agonist, even ten times more selective than clonidine, that is analgesic, has anaesthetic sparing effect, sympatholytic property, useful in other procedural sedation and also has cardiovascular stabilizing property.
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Dexmedetomidine: An adjuvant making large inroads into clinical practice
TL;DR: A review of dexmedetomidine was carried out after searching the medical literature in Pubmed, Science direct, Scopus, Google scholar and various text books and journal articles as mentioned in this paper.
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The Preventive Effect of Dexmedetomidine Against Postoperative Intra-abdominal Adhesions in Rats
Serdar Kuru,Osman Bahadir Bozkirli,Aziz Mutlu Barlas,Mehmet Esat Duymus,Mehmet Senes,Nihat Yumuşak,Cevdet Yilmaz,Kemal Kismet +7 more
TL;DR: The results of this study show that dexmedetomidine had a significant preventive effect on postoperative intra-abdominal adhesions and concluded that these effects might be due to antioxidant and anti-inflammatory activities.
Journal Article
Pain Management Strategies To Reduce Opioid Use Following Total Knee Arthroplasty.
TL;DR: The optimal solution for postoperative TKA pain management has yet to be determined; knee braces have been identified as one potentially successful option and should be widely recommended for patient use.
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Role of Intravenous Dexmedetomidine in Prolonging Postoperative Analgesia and Quality of Block Following Spinal Anaesthesia. A Systemic Review and Update
TL;DR: A systemic review was done to evaluate and provide update on the use of intravenous dexmedetomidine as an adjunct for spinal anaesthesia and current literatures suggest a ceiling effect on prolonging post-spinal analgesia after 0.5 mcg/kg boluses.
References
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Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial.
Richard R. Riker,Yahya Shehabi,Paula M. Bokesch,Daniel Ceraso,Wayne Wisemandle,Firas Koura,Patrick Whitten,Benjamin D. Margolis,Daniel W. Byrne,E. Wesley Ely,Marcelo G. Rocha +10 more
TL;DR: At comparable sedation levels, dexmedetomidine-treated patients spent less time on the ventilator, experienced less delirium, and developed less tachycardia and hypertension.
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The effects of increasing plasma concentrations of dexmedetomidine in humans.
TL;DR: In this article, the responses to increasing plasma concentrations of dexmedetomidine in humans were determined, and 10 healthy men (20-27 yr) provided informed consent and were monitored (underwent electrocardiography, measured arterial, central venous [CVP] and pulmonary artery [PAP] pressures,
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Effect of Sedation With Dexmedetomidine vs Lorazepam on Acute Brain Dysfunction in Mechanically Ventilated Patients: The MENDS Randomized Controlled Trial
Pratik P. Pandharipande,Brenda T. Pun,Daniel Herr,Mervyn Maze,Timothy D. Girard,Russell R. Miller,Ayumi Shintani,Jennifer L. Thompson,James C. Jackson,Stephen A. Deppen,Renée A. Stiles,Robert S. Dittus,Gordon R. Bernard,E. Wesley Ely +13 more
TL;DR: In mechanically ventilated ICU patients managed with individualized targeted sedation, use of a dexmedetomidine infusion resulted in more days alive without delirium or coma and more time at the targeted level of sedation than with a lorazepam infusion.
Dexmedetomidine vs Midazolam for Sedation of Critically Ill Patients
Richard R. Riker,Yahya Shehabi,Paula M. Bokesch,Daniel Ceraso,Firas Koura,Patrick Whitten,Benjamin D. Margolis,Daniel W. Byrne,E. Wesley Ely,Marcelo G. Rocha +9 more
TL;DR: In this article, there was no difference in percentage of time within the target RASS range (77.3% for dexmedetomidine group vs 75.1% for midazolam group; difference, 2.2% [95% confidence interval, 14% to 33%]; P <.001).