Vol. 18 No. 3 (2014): Cardioanesthesiology (Special Issue)
REVIEWS

Dexmedetomidine for sedation of cardiosurgical patients

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  • I. Kozlov,
  • L. Krichevskiy
I. Kozlov
V. Negovsky Research Institute of General Reanimatology; N.V. Sklifosovsky Research Institute of Emergency Medicine
Bio
L. Krichevskiy
V. Negovsky Research Institute of General Reanimatology; O.M. Filatov City Clinical Hospital No. 15
Bio
DOI: https://doi.org/10.21688/1681-3472-2014-3-67-75

Published 2014-07-15

Keywords

  • DEXMEDETOMIDINE,
  • SEDATION IN CARDIO SURGICAL PATIENTS,
  • SEDATIVE DRUGS,
  • DELIRIUM IN CARDIO SURGICAL PATIENTS

How to Cite

Kozlov, I., & Krichevskiy, L. (2014). Dexmedetomidine for sedation of cardiosurgical patients. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 18(3), 67–75. https://doi.org/10.21688/1681-3472-2014-3-67-75

Copyright (c) 2014 Kozlov I.A., Krichevskiy L.A.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

The problem of sedation in cardiosurgical intensive care units has obvious scientific and practical relevance. Many current studies deal with the implementation of novel medications for sedation, some features of their pharmacodynamic effects in different clinical settings, with advantages and disadvantages of their use in cardiosurgical patients. Recent years have seen an increase in the number of publications on the α2-adrenoceptor agonist dexmedetomidine used for sedation after open-heart surgery. The paper reviews current publications on α2-adrenoceptor agonists used in anesthesiology, considers their physiology and the mechanism of sedative action of dexmedetomidine, its pharmacokinetics and pharmacodynamics. The experience in using dexmedetomidine sedation in clinical practice is discussed in detail, by analyzing the data of current multicenter randomized trials in which this drug was compared with other sedative medications (propofol, midazolam, lorazepam). Some aspects of clinical pharmacology of dexmedetomidine, such as its effect on the sympathoadrenal system, hemodynamics, and respiratory system are analyzed. The clinical value of different receptor-dependent effects of the drug and the specific features of its application in different situations are also discussed. The authors share their own experience on delirium treatment and non-invasive ventilation in patients who receive dexmedetomidine sedation after heart transplantation and cardiac surgery.

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