Dexmedetomidine: sedation, analgesia and beyond.
BACKGROUND
Dexmedetomidine is an alpha-2 adrenoreceptor agonist with sedative, analgesic and anxiolytic properties. Since its release in the US market in late 1999, it has gained remarkable attention in the adult, pediatric and geriatric populations, predominantly because of its minimal respiratory depression. However, beyond its well-known properties, dexmedetomidine has recently been investigated for its potential in many other clinical scenarios, including neuroprotection, cardioprotection and renoprotection, with promising results.


OBJECTIVE
This review provides an outline of the current use of dexmedetomidine in adult and pediatric populations in several clinical settings, including operating room, intensive care unit, postsurgical patients and patients who need sedation and/or analgesia for invasive and noninvasive procedures. Our objectives were to examine the most up-to-date clinical evidence, describe the magnitude of effects, and shed some light on potential future applications.


METHODS
Published, peer-reviewed studies, including preclinical data, were included in this review article.


CONCLUSIONS
Dexmedetomidine is a novel agent with a wide safety margin and excellent sedative and moderate analgesic properties. Though its broadest use is currently in surgical and nonsurgical intensive care unit patients, dexmedetomidine appears to have promising future applications in the areas of neuroprotection, cardioprotection and renoprotection.
Chrysostomou
Constantinos
C
University of Pittsburgh Medical Center, Children's Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213, USA. chrycx@chp.edu
Schmitt
Carol G
CG
D000316:Adrenergic alpha-Agonists / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D000758:Anesthesia; D000818:Animals; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*; D004347:Drug Interactions; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics / Q000494:pharmacology*
D000316:Adrenergic alpha-Agonists; D018712:Analgesics, Non-Narcotic; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine