Abstract
Dexmedetomidine (DEX) is currently used as a sedative with or without artificial ventilation in critical care patients in Japan. Originally, DEX had been investigated as an adjunct to general anesthesia in order to decrease the dose of inhaled anesthetics. However, clinical investigation of it as an adjunct to general anesthesia was suspended worldwide. Recently, the unique property of DEX, i.e., the fact that it exhibits almost no respiratory depression, has favored its development as a sedative in monitored anesthesia care (MAC) during surgery. In the United States, DEX was approved in 2009 as a sedative during awake fiberoptic intubation and MAC. In this manuscript, we describe our experiences using DEX as an adjunct to anesthesia during a neurosurgical procedure, as a sedative during awake fiberoptic intubation, in MAC during closure of the head after awake craniotomy, or in MAC during bronchoplastic surgery in a patient with bronchial stenosis. Our experience suggests that DEX is a very useful and safe sedative in patients with spontaneous ventilation without any airway device, especially in the case of airway stenosis. The approval of DEX as a sedative during MAC in Japan is expected.
