Dexmedetomidine is a new analgesic and anxiolytic used in the intensive care setting. It has been indicated for use for less than 24 hours to aid in intubation or extubation of a patient. The advantages for dexmedetomidine compared with propofol or benzodiazepines are that it has fewer sedating effects and a short half-life. Several retrospective studies and case reports have reported its use longer than the indicated 24 hours. They reported that dexmedetomidine is safe to use past the 24-hour indicated time of use, with the same or fewer adverse side effects reported.
Shehabi Y., Ruettimann U., Adamson H., Innes R., Ickeringill M.Dexmedetomidine infusion for more than 24 hours in critically ill patients: sedative and cardiovascular effects. Intensive Care Med.2004;30:2188-2196.
Martin E., Ramsay G., Mantz J., Sum-Ping STThe role of the alpha2-adrenoceptor agonist dexmedetomidine in postsurgical sedation in the intensive care unit. J Intensive Care Med.2003;18:29-41.
5.
Venn RM, Hell J., Grounds RMRespiratory effects of dexmedetomidine in the surgical patient requiring intensive care. Crit Care. 2000;4:302-308.
6.
Micromedex® Healthcare Series [Internet database]. Greenwood Village, CO: Thomson Micromedex [updated periodically].
7.
Dasta JF, Kane-Gill SL, Durtschi AJ. Comparing dexmedetomidine prescribing patterns and safety in the naturalistic setting versus published data. Ann Pharmacother.2004;38: 1130-1135.
8.
MacLaren R., Forest LK, Kiser THAdjunctive dexmedetomidine therapy in the intensive care unit: a retrospective assessment of impact on sedative and analgesic requirements, levels of sedation and analgesia, and ventilatory and hemodynamic parameters. Pharmacotherapy. 2007;27:351-359.
9.
Talke P., Li J., Jain U., et al. Effects of perioperative dexmedetomidine infusion in patients undergoing vascular surgery. Anesthesiology. 1995;82:620-633.
10.
Riker RR, Ramsay MAE, Prielipp RC, Jorden V.Long-term dexmedetomidine infusions for ICU sedation: a pilot study [abstract] . Anesthesiology. 2001;95:A383.
11.
Multz A.Prolonged dexmedetomidine infusion as an adjunct in treating sedation-induced withdrawal. Anesth Analg.2003;96:1054-1055.
12.
Dasta JF, Jacobi J., Sesti AM, McLaughlin TPAddition of dexmedetomidine to standard sedation regimens after cardiac surgery: an outcomes analysis. Pharmacotherapy. 2006 ;26: 798-805.
