[Dexmedetomidine, a promising drug]

Abstract

Surgical patients and others admitted to recovery and intensive care units require sedation and pain therapy, for which a range of pharmaceuticals is available. Their use is more or less widespread, but other drugs, such as dexmedetomidine, have been and continue to be studied for application in such patients. Dexmedetomidine, a compound derived from imidazole, has a high affinity for the alpha-2 adrenoreceptor, on which it acts as a potent agonist. A large number of laboratory and animal studies have been performed, as have clinical trials enrolling healthy volunteers or patients with the aim of shedding shed light on the main pharmacological features of dexmedetomidine. As a result, dexmedetomidine is known to have sedative, hypnotic and analgesic properties. It diminishes the need for other anesthetics and sympathicolytics, and it reduces catecholamine release. Controlled clinical trials have looked at the use of dexmedetomidine in patients who require sedation and analgesia in postoperative intensive care units. Research shows that dexmedetomidine lowers the need both for other sedatives, such as propofol or midazolam, and for analgesic morphine. Moreover, its effect on ventilation is scarce. Dexmedetomidine is presently distributed in the United States but not in the European Union. The aim of this review was to outline the main pharmacological properties of dexmedetomidine, including its pharmacokinetics and pharmacodynamics, to give an overall view of this promising drug.