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Specialty Practice Pharmacist, The Ohio State University Medical Center; Clinical Assistant Professor, College of Pharmacy, The Ohio State University, Columbus, OH
Professor, College of Pharmacy, The Ohio State University
Reprints: Dr. Gerlach, Room 368 Doan Hall, 410 W. Tenth Ave., Columbus, OH 43210, fax 614/293-3165, Gerlach.6{at}osu.edu
OBJECTIVE: To review recent literature on the safety and efficacy of dexmedetomidine.
DATA SOURCES: Articles were identified through searches of MEDLINE
(1966-January 2007). Key words included dexmedetomidine, medetomidine,
2-agonist, and sedation. References from selected
articles were reviewed for additional references.
STUDY SELECTION AND DATA EXTRACTION: Experimental and observational studies that focused on the safety and efficacy of dexmedetomidine in humans were selected.
DATA SYNTHESIS: Dexmedetomidine is an
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.
Key Words: 2-agonist, dexmedetomidine, sedation
Published Online, February 13, 2007. www.theannals.com, DOI 10.1345/aph.1H314
THIS ARTICLE IS APPROVED FOR CONTINUING EDUCATION CREDIT
ACPE
UNIVERSAL PROGRAM NUMBER: 407-000-07-006-H01
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