Dexmedetomidine: an updated review.
OBJECTIVE
To review recent literature on the safety and efficacy of dexmedetomidine.


METHODS
Articles were identified through searches of MEDLINE (1966-January 2007). Key words included dexmedetomidine, medetomidine, alpha(2)-agonist, and sedation. References from selected articles were reviewed for additional references.


METHODS
Experimental and observational studies that focused on the safety and efficacy of dexmedetomidine in humans were selected.


RESULTS
Dexmedetomidine is an alpha(2)-agonist for short-term sedation in critically ill patients. In postoperative patients, dexmedetomidine produced similar levels of sedation and times to extubation, with less opioid requirements compared with propofol. Dexmedetomidine has also been studied for sedation in critically ill medical and pediatric patients, as adjunct to anesthesia, and for procedural sedation. Hypotension, hypertension, and bradycardia are common adverse effects. Although dexmedetomidine is labeled only for sedation less than 24 hours, it has been administered for longer than 24 hours without apparent development of rebound hypertension and tachycardia.


CONCLUSIONS
Dexmedetomidine is a safe and effective agent for sedation in critically ill patients. Further, well designed studies are needed to define its role as a sedative for critically ill medical, neurosurgical, and pediatric patients, as an adjunct to anesthesia, and as a sedative during procedures.
Gerlach
Anthony T
AT
The Ohio State University Medical Center, The Ohio State University, Columbus, OH, USA. Gerlach.6@osu.edu
Dasta
Joseph F
JF
D058669:Adrenergic alpha-2 Receptor Antagonists; D003422:Critical Care / Q000379:methods*; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016239:MEDLINE; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome
D058669:Adrenergic alpha-2 Receptor Antagonists; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine