Dexmedetomidine: Current Role in Anesthesia and Intensive Care

Detalhes bibliográficos
Autor(a) principal: Afonso, Joana
Data de Publicação: 2012
Outros Autores: Reis, Flávio
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10316/102718
https://doi.org/10.1016/S0034-7094(12)70110-1
Resumo: Background and objectives: To update and review the application of dexmedetomidine in anesthesia and intensive care. This study is a comprehensive review of clinical uses, pharmacology, pharmacokinetics, mechanism of action and adverse effects of dexmedetomidine. Content: The effective use of sedative-hypnotic agents and analgesics is an integral part of comfort and safety of patients. Dexmedetomidine is a potent and highly selective α-2 adrenoceptor agonist with sympatholytic, sedative, amnestic, and analgesic properties, which has been described as a useful and safe adjunct in many clinical applications. It provides a unique “conscious sedation”, analgesia, without respiratory depression. The current reviewed uses include sedation at Intensive Care Unit – ICU (both adult and pediatric), emergency department, regional and general anesthesia, neurosurgery, sedation for pediatric procedures, awake fiber-optic intubation, cardiac surgery and bariatric surgery. Conclusions: Dexmedetomidine offers a unique ability of providing both sedation and analgesia without respiratory depression. It is a new agent with a wide safety margin, excellent sedative capacity and moderate analgesic properties. Although its wide use is currently in patients of surgical and non-surgical intensive care units, dexmedetomidine seems to have promising future applications in neuroprotection, cardioprotection and renoprotection. More detailed studies are required to define its role as sedative in critical, neurosurgical and pediatric patients, as anesthesia adjunct and sedative during procedures.
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spelling Dexmedetomidine: Current Role in Anesthesia and Intensive CareDexmedetomidina: Papel Atual em Anestesia e Cuidados IntensivosDexmedetomidineAnesthesia, AnalgesiaIntensive CareBackground and objectives: To update and review the application of dexmedetomidine in anesthesia and intensive care. This study is a comprehensive review of clinical uses, pharmacology, pharmacokinetics, mechanism of action and adverse effects of dexmedetomidine. Content: The effective use of sedative-hypnotic agents and analgesics is an integral part of comfort and safety of patients. Dexmedetomidine is a potent and highly selective α-2 adrenoceptor agonist with sympatholytic, sedative, amnestic, and analgesic properties, which has been described as a useful and safe adjunct in many clinical applications. It provides a unique “conscious sedation”, analgesia, without respiratory depression. The current reviewed uses include sedation at Intensive Care Unit – ICU (both adult and pediatric), emergency department, regional and general anesthesia, neurosurgery, sedation for pediatric procedures, awake fiber-optic intubation, cardiac surgery and bariatric surgery. Conclusions: Dexmedetomidine offers a unique ability of providing both sedation and analgesia without respiratory depression. It is a new agent with a wide safety margin, excellent sedative capacity and moderate analgesic properties. Although its wide use is currently in patients of surgical and non-surgical intensive care units, dexmedetomidine seems to have promising future applications in neuroprotection, cardioprotection and renoprotection. More detailed studies are required to define its role as sedative in critical, neurosurgical and pediatric patients, as anesthesia adjunct and sedative during procedures.Justificativa e objetivos: Atualizar e rever a aplicação da dexmedetomidina em anestesia e cuidados intensivos. Este trabalho é uma revisão abrangente dos usos clínicos, farmacologia, farmacocinética, mecanismo de ação e efeitos adversos da dexmedetomidina. Conteúdo: O uso efetivo de agentes sedativo-hipnóticos e analgésicos é parte integral do conforto e segurança dos pacientes. A dexmedetomidina é um potente e altamente seletivo agonista dos adrenoceptores α-2 com propriedades simpaticolíticas, sedativas, amnésicas e analgésicas, que tem sido descrito como um adjuvante útil e seguro em várias aplicações clínicas. Proporciona uma “sedação consciente” única, analgésica, sem depressão respiratória. Os usos correntes revistos incluem sedação na unidade de tratamento intensivo – UTI (adulta e pediátrica), departamento de emergência, anestesia regional e geral, neurocirurgia, sedação para procedimentos pediátricos, intubação por fibra ótica em doentes acordados, cirurgia cardíaca e cirurgia bariátrica. Conclusões: A dexmedetomidina oferece a capacidade única de fornecer sedação e analgesia sem depressão respiratória. É um agente novo com uma grande margem de segurança, excelente capacidade sedativa e moderadas propriedades analgésicas. Embora o seu amplo uso seja, atualmente, em pacientes de unidades de cuidados intensivos cirúrgicos e não cirúrgicos, a dexmedetomidina parece ter futuras aplicações promissoras nas áreas de neuroproteção, cardioproteção e renoproteção. São necessários mais estudos detalhados para definir o seu papel como sedativo em doentes críticos, neurocirúrgicos e pediátricos, como adjuvante da anestesia e como sedativo durante procedimentos.2012info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articlehttp://hdl.handle.net/10316/102718http://hdl.handle.net/10316/102718https://doi.org/10.1016/S0034-7094(12)70110-1eng00347094Afonso, JoanaReis, Flávioinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-10-10T20:31:36Zoai:estudogeral.uc.pt:10316/102718Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T21:19:39.306765Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Dexmedetomidine: Current Role in Anesthesia and Intensive Care
Dexmedetomidina: Papel Atual em Anestesia e Cuidados Intensivos
title Dexmedetomidine: Current Role in Anesthesia and Intensive Care
spellingShingle Dexmedetomidine: Current Role in Anesthesia and Intensive Care
Afonso, Joana
Dexmedetomidine
Anesthesia, Analgesia
Intensive Care
title_short Dexmedetomidine: Current Role in Anesthesia and Intensive Care
title_full Dexmedetomidine: Current Role in Anesthesia and Intensive Care
title_fullStr Dexmedetomidine: Current Role in Anesthesia and Intensive Care
title_full_unstemmed Dexmedetomidine: Current Role in Anesthesia and Intensive Care
title_sort Dexmedetomidine: Current Role in Anesthesia and Intensive Care
author Afonso, Joana
author_facet Afonso, Joana
Reis, Flávio
author_role author
author2 Reis, Flávio
author2_role author
dc.contributor.author.fl_str_mv Afonso, Joana
Reis, Flávio
dc.subject.por.fl_str_mv Dexmedetomidine
Anesthesia, Analgesia
Intensive Care
topic Dexmedetomidine
Anesthesia, Analgesia
Intensive Care
description Background and objectives: To update and review the application of dexmedetomidine in anesthesia and intensive care. This study is a comprehensive review of clinical uses, pharmacology, pharmacokinetics, mechanism of action and adverse effects of dexmedetomidine. Content: The effective use of sedative-hypnotic agents and analgesics is an integral part of comfort and safety of patients. Dexmedetomidine is a potent and highly selective α-2 adrenoceptor agonist with sympatholytic, sedative, amnestic, and analgesic properties, which has been described as a useful and safe adjunct in many clinical applications. It provides a unique “conscious sedation”, analgesia, without respiratory depression. The current reviewed uses include sedation at Intensive Care Unit – ICU (both adult and pediatric), emergency department, regional and general anesthesia, neurosurgery, sedation for pediatric procedures, awake fiber-optic intubation, cardiac surgery and bariatric surgery. Conclusions: Dexmedetomidine offers a unique ability of providing both sedation and analgesia without respiratory depression. It is a new agent with a wide safety margin, excellent sedative capacity and moderate analgesic properties. Although its wide use is currently in patients of surgical and non-surgical intensive care units, dexmedetomidine seems to have promising future applications in neuroprotection, cardioprotection and renoprotection. More detailed studies are required to define its role as sedative in critical, neurosurgical and pediatric patients, as anesthesia adjunct and sedative during procedures.
publishDate 2012
dc.date.none.fl_str_mv 2012
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http://hdl.handle.net/10316/102718
https://doi.org/10.1016/S0034-7094(12)70110-1
url http://hdl.handle.net/10316/102718
https://doi.org/10.1016/S0034-7094(12)70110-1
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