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Current Pharmaceutical Design

Eiditor-in-Chief

ISSN (Print): 1381-6128
ISSN (Online): 1873-4286

Dexmedetomidine: A Review of its Use for the Management of Pain, Agitation, and Delirium in the Intensive Care Unit

Author(s): Kevin E. Anger

Volume 19 , Issue 22 , 2013

Page: [4003 - 4013] Pages: 11

DOI: 10.2174/1381612811319220009

Price: $58

Abstract

Management of pain, agitation, and delirium is a complex process requiring a multimodal approach to optimize patient outcomes. Dexmedetomidine is a centrally acting alpha-2 agonist with sedative and analgesic properties that has demonstrated efficacy in managing pain, agitation, and delirium in a variety of critically ill patient populations. Dexmedetomidine has demonstrated the ability to provide a mild to moderate level of sedation in diverse ICU populations compared to conventional sedative regimens. Recent literature has demonstrated improved outcomes with dexmedetomidine based vs. benzodiazepine based sedation therapy in select mechanically ventilated ICU patients. However, dexmedetomidine therapy has also been associated with adverse cardiovascular events including hypotension, bradycardia, and asystole. The clinical pharmacology, therapeutic efficacy, safety considerations, controversies, and future directions of dexmedetomidine therapy in the ICU setting will be discussed.

Keywords: Dexmedetomidine, intensive care unit, sedation, agitation, pain, analgesia, and delirium.


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