Dexmedetomidine in intensive care unit: a study of hemodynamic changes.
BACKGROUND
Dexmedetomidine is a potent new alpha-2 adrenoceptor agonist with an alpha-2 to alpha- ratio more than 7 times that of clonidine. Its potent sedative, analgesic and sympatholytic effects blunt the cardiovascular responses (hypertension, tachycardia) without unexpected toxicity. Many reports confirmed its pharmacological properties if given by infusion. Recent report confirmed favorable non-depressant effect on respiration and blood gases.


METHODS
ICU patients at King Khalid University Hospital.


METHODS
Open label clinical evaluation on ten surgical patient ASA I class received dexmeditomidine infusion to the sedative effect level of Ramsy scale of 3 for ventilated patients and 2 for spontaneously breathing patient. The clinical observation and analgesic requirement as well as the hemodynamic parameters and hemoglobin oxygen saturation were observed for the period of ventilation and weaning till discharge from the ICU. These records were subjected to paired t test for values measured at preinfusion period compared to 10 minutes and 6 hours measurement after infusion.


RESULTS
The study confirmed the previous findings of previous reports regarding the cardiovascular stability and non depressive effect on respiration. It also confirmed the sparing effect on the use of analgesics which indicates its analgesic effect. The sedation quality is unique in that the patient is easily arousable. This was reported favorably by the nursing staff. Bradycardia was observed in one patient who was treated effectively by stopping the infusion.


CONCLUSIONS
We concluded that dexmedetomidine is useful sedative agent with analgesic properties which reduce the analgesic requirement of the patient. The patient were ventilated, weaned, then breathed spontaneously in a satisfactory manner.
Takrouri
Mohamad Said
MS
King Saud University Medical College, P.O. Box: 2925(41), Riyadh 11461, KSA. takrouri@ksu.edu.sa
Seraj
Mohamad Abdulla
MA
Channa
Amir B
AB
el-Dawlatly
Abdel Azeem
AA
Thallage
Ahmad
A
Riad
Walid
W
Khalaf
Mazer
M
D000316:Adrenergic alpha-Agonists / Q000627:therapeutic use*; D000328:Adult; D020927:Dexmedetomidine / Q000627:therapeutic use*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D013514:Surgical Procedures, Operative; D013997:Time Factors
D000316:Adrenergic alpha-Agonists; D020927:Dexmedetomidine