Dexmedetomidine

Abstract Dexmedetomidine is unique as it produces “cooperative sedation.” It has axiolytic, sedative and analgesic properties. Dexmedetomidine acts as an alpha2-adrenergic receptor agonist in a similar way to clonidine. It decreases the dose requirement of inhaled and intravenous anesthetics as well as opioids and benzodiazepines. Dexmedetomidine maintains the airway and spontaneous ventilation, thereby enhancing the safety of awake fiberoptic intubation. There is blunting of the sympathetic response to noxious stimuli, making for stable hemodynamics throughout a surgical case. Emergence delirium is minimized compared with other sedatives, and dexmedetomidine has a sparing effect on postoperative opioids. Dexmedetomidine can facilitate a balances anesthetic technique when combined with other sedatives such as benzodiazepines, opioids and propofol. It is not recommended for long term sedation.