title: Alpha-2 agonists: can they modify the outcomes in the Postanesthesia Care Unit?
abstract: While most patients recover uneventfully from the effects of anesthesia and surgery, for a small percentage of patients the immediate postoperative period can be a period of significant physiological stress. Hence the goal for a Post Anesthesia Care Unit (PACU) is to provide a safe environment for a patient to recover, while avoiding the undesirable side effects of pain, nausea, vomiting and shivering, and to monitor for potentially life threatening hemodynamic and respiratory complications that may require admission into the intensive care unit (ICU). Anesthetic techniques in the operating room are extremely important as these may have significant bearing on the post-operative course. The type of surgery, the patients' co morbid conditions, anticipated extubation and recovery of the patient, as well as the sophistication of the PACU and the expertise of its staff, all influence the choice of anesthetic technique. These agents, however, may themselves contribute to some of the complications and unpleasant events encountered in the PACU. Therefore, evaluation of newer and safer agents, which promote a smoother PACU transition, are warranted. Alpha 2 agonists are increasingly being used as adjuvant therapeutic agents in the perioperative period because of their ability to block the sympathetic stress response, complete with their anesthetic and analgesic sparing properties, lack of respiratory depression and low and predictable side effect profile.
authors.affiliation: Department of Anesthesiology, Division of Critical Care Medicine, Vanderbilt University School of Medicine, 324 MAB, 21st Ave South, Nashville, TN 37232, USA. pratik.pandharipande@vanderbilt.edu
authors.forename: P
authors.initials: P
authors.lastname: Pandharipande
authors.forename: E W
authors.initials: EW
authors.lastname: Ely
authors.forename: M
authors.initials: M
authors.lastname: Maze
mesh_terms: D000316:Adrenergic alpha-Agonists / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000762:Anesthesia Recovery Period; D006801:Humans; D011183:Postoperative Complications / Q000188:drug therapy*; D018341:Receptors, Adrenergic, alpha-2 / Q000187:drug effects / Q000502:physiology; D011997:Recovery Room
chemical_list: D000316:Adrenergic alpha-Agonists; D018341:Receptors, Adrenergic, alpha-2