Episode 14: Dexmedetomidine

clinical pharmacology Jun 01, 2020

Episode Summary

In this episode of the APEX Live Anesthesia Podcast, it’s all about dexmedetomidine. Or, simply… just dex. We’ll discuss its pharmacological properties and share clinically relevant content related to its use in clinical anesthesia.


What You'll Learn

  • What are the important pharmacodynamic and pharmacokinetic effects of dexmedetomidine?
  • How does dexmedetomidine produce anesthetic effects?
  • What are the published dosing guidelines for dexmedetomidine?
  • Are there significant side effects when administering dexmedetomidine?
  • How can dexmedetomidine be used in clinical anesthesia?


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Recommended Resources

  1. Abdel-Ghaffar HS. Oral trans-mucosal dexmedetomidine for controlling of emergence agitation in children undergoing tonsillectomy: a randomized controlled trial. Rev Bras Anestesiol. 2019. 69(5):469-476. 
  2. Azemati S. Effects of Adding Dexmedetomidine to Local Infiltration of Bupivacaine on Postoperative Pain in Pediatric Herniorrhaphy; A Randomized Clinical Trial. Korean J Anesthesiol. 2019 Oct 22. 
  3. Eskandr AM. Dexmedetomidine as Part of a General Anesthetic for Caesarean Delivery in patients with Preeclampsia: A randomized double blinded trial. Eur J Anesthesiol. 2018. 35(5): 372-378.
  4. Farrell D. Perioperative Management of Severe Traumatic Brain Injury: What is New? Curr Anesthesiol Rep. 2018. 8(3): 279.289.
  5. Flanders CA. The effect of dexmedetomidine and clonidine on the inflammatory response in critical illness: a systematic review of animal and human studies. Crit Care. 2019. 23(1):402. 
  6. Gajewski M. Transient Asystole after Sugammadex Administration for Immediate Reversal of Deep Blockade while on Dexmedetomidine Infusion in a Super Obese Patient. Case Rep Anesthesiol. 2019: 2709568. Published online 2019 May 21.  
  7. Gertler R. Dexmedetomidine: A Novel Sedative-Analgesic Agent. Proc (Bayl Univ Med Cent). 2001. 14(21). 13-21.
  8. Hashemi M. Effects of Caudal Epidural Dexmedetomidine on Pain, Erythrocyte Sedimentation Rate and Quality of Life in Patients with Failed Back Surgery Syndrome; A Randomized Clinical Trial. Bull Emerg Trauma. 2019 Jul;7(3):245-250. 
  9. Kandil A. Comparison of the combination of dexmedetomidine and ketamine to propofol or propofol/sevoflurane for drug-induced sleep endoscopy in children. Paediatr Anaesth. 2016 Jul;26(7):742-51. 
  10. Kaur M, Singh PM. Current role of dexmedetomidine in clinical anesthesia and intensive care. Anesth Essays Res. 2011;5(2):128–133. 
  11. Li WX. Effects of propofol, dexmedetomidine, and midazolam on postoperative cognitive dysfunction in elderly patients: a randomized controlled preliminary trial. Chin Med J. 2019 Feb;132(4):437-445. 
  12. Liu L. Intrathecal dexmedetomidine can decrease the 95% effective dose of bupivacaine in spinal anesthesia for cesarean section: A prospective, double-blinded, randomized study. Medicine (Baltimore). 2019.;98(9):e14666. 
  13. Minagar M. The efficacy of addition of dexmedetomidine to intrathecal bupivacaine in lower abdominal surgery under spinal anesthesia. Caspian J Intern Med. 2019.10(2):142-149.
  14. Ramya Parameswari A. Comparison of Efficacy of Bupivacaine with Dexmedetomidine Versus Bupivacaine Alone for Transversus Abdominis Plane Block for Post-operative Analgesia in Patients Undergoing Elective Caesarean Section. J Obstet Gynaecol India. 2018 Apr;68(2):98-103.
  15. Schnabel A. Efficacy and safety of dexmedetomidine in peripheral nerve blocks: A meta-analysis and trial sequential analysis. Eur J Anesthesiol. 2018. 35(10):745-758.
  16. Shaikh SI. Comparison of Epidural Clonidine and Dexmedetomidine for Perioperative Analgesia in Combined Spinal Epidural Anesthesia with Intrathecal Levobupivacaine: A Randomized Controlled Double-blind Study. Anesth Essays Res. 2017.11(2):503-507.
  17. Wang YQ. Effect of intrathecal dexmedetomidine on cesarean section during spinal anesthesia: a meta-analysis of randomized trials. Drug Des Devel Ther. 2019;13:2933-2939.
  18. Weerink M. Clinical Pharmacokinetics and Pharmacodynamics of Dexmedetomidine. Clin Pharmacokinet. 2017. 56(8):893-913.
  19. Xia F. The effect of intrathecal dexmedetomidine on the dose requirement of hyperbaric bupivacaine in spinal anaesthesia for caesarean section: a prospective, double-blinded, randomized study. BMC Anesthesiol. 2018 Jun 23;18(1):74. 


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APEX Anesthesia Review, LLC and APEX Live expressly disclaim any liability in connection with the use of any content in its podcasts, social media posts, and all other published content by any third party.

Podcast music by Eino Toivanen, kongano.com


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