Pregledni rad
https://doi.org/10.26800/LV-145-supl4-13
Dexmedetomidine in perioperative period
Nikola Lesar
; Zavod za anesteziologiju, reanimatologiju i intenzivno liječenje, Klinika za tumore, Zagreb, Hrvatska
Burim Muhaxhiri
Gordana Brozović
Sažetak
Dexmedetomidine is an anesthetic generally used in clinical practice during perioperative period. It is a selective α2-adrenergic receptor (α2-AR) agonist. The target sites of action are the α2-AR on locus ceruleus of the brainstem (sedation and vagomimetic effect) and the spinal cord (analgesia). The drug is completely biotransformed in the body by direct glucuronidation and the hepatic p450 enzyme system into an inactive metabolite that is excreted in the urine. Its action is associated with analgesic effects (inhibition of the release of antinociceptive
transmitters such as substance P and glutamate) and sedation effects that reduce the need for the use of opioids in the perioperative period, reduced occurrence of delirium and agitation in intensive care units. Apparently due to its rapid onset and predictable cessation of action, and the existence of an antidote, it is increasingly used in clinical settings and is currently used as a premedication, during the induction and maintenance of anesthesia intraoperatively, in regional anesthesia and for sedation in intensive care units. Furthermore, it is suitable for use during short-term outpatient procedures such as colonoscopy, transesophageal echocardiography and lithotripsy. Its unique property of imitating the natural state of sleep and the possibility of easy awakening, as well as its neuroprotective effect, make it suitable for use in neurosurgical patients in intensive care units. There are also adverse effects of Dexmedetomidine such as bradycardia and hemodynamic instability, which is why it is recommended to avoid giving a loading dose. The latest studies also warn of the harmfulness of long-term administration of Dexmedtomidine and of increased mortality compared to patients sedated with Propofol or Midazolam.
Ključne riječi
DEXMEDETOMIDINE; SEDATION; ANALGESIA; ADVERSE EFFECTS
Hrčak ID:
310273
URI
Datum izdavanja:
20.11.2023.
Posjeta: 205 *