Abstract
Dexmedetomidine (DEX), an α2-adrenoceptor agonist which has been used frequently to create better sedation in the Intensive Care Unit (ICU), shortens the duration of artificial respiratory management, resulting in a reduced incidence of respiratory infection including ventilator associated pneumonia. DEX has a neuroprotective effect on the central nervous system through both direct action on the α2A-adrenoceptor on the impaired nerve and indirect action via the α2A-adrenoceptor on the astrocyte to develop brain-derived neurotrophic factor. This effect is likely to decrease the incidence of delirium and postoperative cognitive dysfunction in the ICU. Moreover, DEX has an immunomodulatory action that suppresses production of cytokines, which leads to a reduced degree of systemic inflammatory responses.
Using DEX to sedate patients under local and regional anesthesia makes it easy to attain the level of “conscious sedation”, which means patients are asleep but easy to awaken with light stimuli. DEX has an analgesic effect via α2-adrenoceptor on the dorsal horn of the spine, thereby eliminating the need for analgesics during anesthesia management. Systemic administration of DEX prolongs the duration of neural blockade in both local and regional anesthesia. Sedation with DEX during local or regional anesthesia may provide benefits to patients by its above-mentioned pharmacological actions.
