The role of the α2-adrenoceptor agonist dexmedetomidine in postsurgical sedation in the intensive care unit

Eike Martin, Graham Ramsay, Jean Mantz, S. T John Sum-Ping

Research output: Contribution to journalArticle

191 Scopus citations

Abstract

Dexmedetomidine was evaluated for sedation of 401 post-surgical patients in this double-blind, randomized, placebo-controlled, multicenter trial. Dexmedetomidine or saline was started on arrival in the intensive care unit (ICU) (1.0 mcg/kg for 10 minutes), then titrated at 0.2 to 0.7 mcg/kg/h to effect. Patients could be given propofol if necessary. Morphine was administered for pain. Sixty percent of the dexmedetomidine patients required no other sedative to maintain an RSS ≥ 3; 21% required < 50 mg propofol. In contrast, 76% of the control group received propofol; 59% required ≥ 50 mg. Dexmedetomidine patients required significantly less morphine for pain relief (P < .001). Continuously given throughout the ICU stay, dexmedetomidine had no effect on respiratory rate, oxygen saturation, duration of weaning, or times to extubation. Nurses judged the dexmedetomidine patients were easier to manage. Later, fewer dexmedetomidine patients remembered pain or discomfort. The majority of dexmedetomidine patients maintained blood pressures within normal range, without rebound. Hypertension, atelectasis, and rigors occurred more frequently in the control group, while hypotension and bradycardia occurred more frequently in the dexmedetomidine group. Preoperative cardiovascular conditions were not risk factors for dexmedetomidine patients.

Original languageEnglish (US)
Pages (from-to)29-41
Number of pages13
JournalJournal of Intensive Care Medicine
Volume18
Issue number1
DOIs
StatePublished - Dec 1 2003

Keywords

  • Anxiety
  • Cardiac artery bypass graft
  • Imidazoles
  • Respiratory system
  • Sympatholysis
  • α-adrenoceptors

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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