Dexmedetomidine, Application in Pediatrics: Paper Review

Abstract:

Introduction: Dexmedetomidine is a drug with sedative, hypnotic, and analgesic properties. Its use in adult sedation was approved in 1999. In children, although the use has not been approved, its application by paediatricians is common. The drug offers many advantages in sedative procedures of paediatric patients. First, the half-life is relatively short. Second, it has little or no effect on respiratory management, and lastly, it is well tolerated by intensive care unit patients found with mechanical ventilation. Pharmacokinetics: 93% of the drug bonds with plasma proteins on absorption. Then, it undergoes a rapid phase of distribution with a half-life of 7 min. It has a depuration rate of 15 ml/kg/min, and half-life elimination rate of 2 h. Pharmacodynamics: The drug has antinociceptive action on α-2A adrenergic receptor of the spinal cord. It has hypnotic-sedative action, and inhibitory effect on central noradrenergic transmission. Applications: It is used as a premedication agent with the objective of getting better cooperation of the patient on starting anaesthetic procedures. Adverse reactions: Bradycardia and hypotension. Conclusion: Its use appears to have a promising future in paediatric population; however, it is pertinent that more controlled clinical studies be carried out in order to demonstrate its safety and efficacy.

Key words: Dexmedetomidine, Pharmacokinetic/pharmacodynamic, Paediatric patients, Adverse reaction, Applications.