title: Dexmedetomidine: review, update, and future considerations of paediatric perioperative and periprocedural applications and limitations.
abstract: Despite lack of paediatric labelling, contributions to the literature on paediatric applications of dexmedetomidine have increased over recent years. Dexmedetomidine possesses many properties that are advantageous for a sedative and anaesthetic; it has been reported to provide sedation that parallels natural sleep, anxiolysis, analgesia, sympatholysis, and an anaesthetic-sparing effect with minimal respiratory depression. In addition, there is increasing evidence supporting its organ-protective effects against ischaemic and hypoxic injury. These favourable physiological effects combined with a limited adverse effect profile make dexmedetomidine an attractive adjunct to anaesthesia (general and regional) for a variety of procedures in paediatric operating rooms. A comprehensive understanding of the pharmacological, pharmacokinetic, and pharmacodynamic effects of dexmedetomidine is critical to maximize its safe, efficacious, and efficient paediatric perioperative applications. This review focuses on the current paediatric perioperative and periprocedural applications of dexmedetomidine and its limitations, with a consideration for the future.
authors.affiliation: Department of Anesthesiology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA mohamed.mahmoud@cchmc.org.
authors.forename: M
authors.initials: M
authors.lastname: Mahmoud
authors.affiliation: Department of Anesthesiology, Perioperative, and Pain Medicine, Boston Children's Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115, USA.
authors.forename: K P
authors.initials: KP
authors.lastname: Mason
mesh_terms: D058109:Airway Management; D018712:Analgesics, Non-Narcotic / Q000494:pharmacology; D000765:Anesthesia, Conduction; D014151:Anti-Anxiety Agents / Q000494:pharmacology; D002648:Child; D020927:Dexmedetomidine / Q000008:administration & dosage / Q000009:adverse effects / Q000494:pharmacology*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000494:pharmacology; D007668:Kidney / Q000187:drug effects; D019635:Neurosurgical Procedures; D019990:Perioperative Care; D011292:Premedication
chemical_list: D018712:Analgesics, Non-Narcotic; D014151:Anti-Anxiety Agents; D006993:Hypnotics and Sedatives; D020927:Dexmedetomidine
keywords: adverse events; anaesthesia; paediatric; pharmacology; sedation