Intraoperative Use of Dexmedetomidine in Pediatric Patients : Advantages and Disadvantages

Abstract

  In pediatric anesthesia, dexmedetomidine (DEX) is used off-label all over the world. I herein describe the present conditions, and the advantages of using DEX based on the current literature.
  DEX is associated with several advantages, including the fact that it induces minimal respiratory depression, and it has a pain-killing effect in addition to an antianxiety effect. The disadvantages of DEX are that it must be used off-label and can lead to changes in blood pressure and heart rate depending on the dose administered.
  In our institution, DEX is used for children aged five to seven years old who are undergoing a pectus excavatum operation and being treated using patient-controlled epidural or intravenous analgesia. We do not use a loading dose because it can lead to changes in blood pressure and heart rate. We start to inject a concentration of 0.4 μg/kg/hr DEX intravenously when the wound is sutured. We can reduce the risk of respiratory failure, allow for smooth extubation, and make the stay in the ICU more comfortable using DEX.
  I believe that the drug will likely be adopted in the future, and it appears to be an especially useful drug in the field of pediatric anesthesia.