Dexmedetomidine: the most versatile and multitasking of anesthetics

摘要

Since its reappearance in the world of anesthesia, dexmedetomidine has achieved multiple successes in many clinical contexts with pharmacodynamic targets, clinical indications and, finally, different and complementary routes of administration for both anesthesiologists and intensivists (Table I).1-20 This drug has found wide application in challenging clinical conditions including light sedation during invasive1 and non-invasive ventilation2 and weaning from mechanical ventilation,3 delirium prevention and treatment,4 analgesia and sedation for uncomfortable procedures in non-intubated patients,5 sleep promotion,6 and, more generally, improvement of the quality of mid- and long-term analgo-sedation in both adult7 and pediatric8 critically ill patients. In addition, dexmedetomidine has proved to be an innovative resource for the prevention and management of postoperative shivering9 and, in combination with other drugs, alcohol withdrawal syndrome.10 Finally, intranasal administration of dexmedetomidine has been mostly adopted for sedation and postoperative pain management in children.