Use of Dexmedetomidine for Anesthesia and Pain Management

Abstract

Background & objective: Since 1999, dexmedetomidine has been used in several patient populations after its approval as a sedative by the FDA. Subsequently, a large number of clinical trials on its benefits have been published widely in the literature. This review aims to update readers regarding recent evidence for approved as well as novel uses of dexmedetomidine and identify future areas of clinical research involving this relatively new drug. Sources: Randomized controlled trials conducted between January 2000 and August 2021, which compared dexmedetomidine with other sedative agents used in adult and pediatric patients undergoing mechanical ventilation in ICU, bronchoscopy and endoscopic procedures, general and locoregional anesthesia and chronic pain management were included in this review of the literature. PubMed, Science Direct, the Cochrane library and Google Scholar were used as databases. Implications: Dexmedetomidine is a multipurpose drug that has found unparalleled utility in intensive care medicine and anesthesiology. Its various advantages over traditional sedative agents have been documented, including decreased duration of mechanical ventilation, decreased incidence of delirium, perioperative analgesia and organ protective properties. Recently there has been mounting interest in dexmedetomidine as an analgesic adjunct in chronic and cancer pain management. However, there is still a paucity of well controlled studies evaluating the use of dexmedetomidine outside of a traditional sedative/analgesic role. The future direction of the research may focus on long term clinical benefits of dexmedetomidine in certain perioperative populations and its non-conventional use in palliative care and pain medicine.  Citation: Ahmed WN, Khan AW. Use of dexmedetomidine for anesthesia and pain management: an updated review of literature. Anaesth. pain intensive care 2022;26(5):702-709; DOI: 10.35975/apic.v26i5.2020