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Dexmedetomidine (By injection)

Keeps you asleep during surgery or other medical procedures.

What works?

Learn more about the effects of these drugs. The most reliable research is summed up for you in our featured article.

Brand names include
Dexmedetomidine HCl Novaplus, Precedex, PremierPro Rx Dexmedetomidine HCl
Drug classes About this
Analgesic, Anesthetic Adjunct, Sedative

What works? Research summarized

Evidence reviews

Dexmedetomidine for Sedation of Patients in the ICU or PICU: Review of Clinical Effectiveness and Safety [Internet]

Sedation of ICU patients is often essential for ICU patients to maximize survival, reduce ICU and hospital stay, and facilitate mechanical ventilation. The standard of care for sedation include benzodiazepine sedatives and propofol. Some drawbacks of the available sedative agents include patients’ agitation and delirium. To overcome these drawbacks, it has been suggested that dexmedetomidine can be an appropriate alternative to traditional sedatives for maintaining light to moderate sedation. However, the Health Canada approved label for dexmedetomidine provides warnings that the drug is associated with hypotension, clinically significant episodes of bradycardia, and sinus arrest.

Dexmedetomidine for Sedation in the ICU or PICU: A Review of Cost-Effectiveness and Guidelines [Internet]

Sedation of ICU patients is often essential for ICU patients to maximize survival, reduce ICU and hospital stay, and facilitate mechanical ventilation. The standard of care for sedation includes benzodiazepine sedatives and propofol. These sedatives (notably benzodiazepines) are associated with an increased risk of agitation and delirium. It has been hypothesized that dexmedetomidine would be an appropriate alternative to traditional sedatives for maintaining light to moderate sedation. Dexmedetomidine is an alpha2-adrenergic agonist, and it is approved in Canada for intensive care unit sedation and conscious sedation. In January 2014, the Canadian Agency for Drugs and Technologies in Health (CADTH) reviewed the evidence on the clinical effectiveness of using dexmedetomidine for sedation in intensive-care unit. Based on the CADTH review, dexmedetomidine was found to be associated with decreased ICU stay and decreased time on mechanical ventilation. However, it was associated with higher rates of bradycardia than comparators.

Dexmedetomidine versus midazolam in anesthetic preoperative administration: a meta-analysis

Bibliographic details: Sun JH, Han N, Wu XY.  Dexmedetomidine versus midazolam in anesthetic preoperative administration: a meta-analysis. Chinese Journal of Evidence-Based Medicine 2009; 9(11): 1231-1237

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Summaries for consumers

Dexmedetomidine for prevention of acute pain after abdominal surgery in adults

Acute pain after surgery is a problem for patients undergoing abdominal surgery. In addition to postoperative pain, the side effects of treatment with pain killers, in particular those of opioids (drugs resembling morphine), need to be reduced. Dexmedetomidine is an opioid sparing drug (reduces the need for opioids). We reviewed the evidence about the effectiveness of dexmedetomidine in reducing the need for opioids and in preventing acute pain after abdominal surgery in adults. We wanted to discover how safe dexmedetomidine was and whether it was effective in preventing some of the known side effects of opioids, such as nausea and vomiting, reduced bowel function and delayed mobilization (getting up and moving around) after abdominal surgery.

Is dexmedetomidine a good option for patients undergoing awake fibreoptic intubation?

This is a review of the clinical evidence from randomized controlled trials on the effect of dexmedetomidine in the management of awake fibreoptic intubation. The review was conducted by researchers in The Cochrane Collaboration. Awake fibreoptic intubation (AFOI) is indicated for the management of patients with a difficult or unstable (critical) airway, such as those with airway deformity or tumour, airway injury or spinal cord instability. It is necessary in such a situation to maintain patient co‐operation and reduce patient anxiety without causing severe adverse effects during the AFOI. Many agents, including fentanyl, remifentanil, midazolam and propofol, have been reported to assist with AFOI. However, these agents can cause respiratory arrest, loss of airway control or reduced cardiovascular (heart) function, especially when used in high doses, thus increasing the risk of low oxygen levels (hypoxaemia), aspiration, low blood pressure (hypotension) or slow heart rate (bradycardia).

Dexmedetomidine and clonidine for long‐term sedation during mechanical ventilation in critically ill patients

We reviewed the evidence about the safety and efficacy of dexmedetomidine and clonidine (known as alpha‐2 agonists) for long‐term sedation during mechanical ventilation in critically ill patients in the intensive care unit (ICU).

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